PD40-02 ONCOLOGIC OUTCOMES AFTER RADICAL PROSTATECTOMY FOR HIGH RISK PROSTATE CANCER: IMPACT OF VARIOUS DEFINITIONS ON CANCER-SPECIFIC AND OVERALL MORTALITY
Notice bibliographique
Résumé
You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I (PD40)1 Apr 2019PD40-02 ONCOLOGIC OUTCOMES AFTER RADICAL PROSTATECTOMY FOR HIGH RISK PROSTATE CANCER: IMPACT OF VARIOUS DEFINITIONS ON CANCER-SPECIFIC AND OVERALL MORTALITY Sophie Knipper*, Pierre Karakiewicz, Thomas Steuber, Markus Graefen, and Derya Tilki Sophie Knipper*Sophie Knipper* More articles by this author , Pierre KarakiewiczPierre Karakiewicz More articles by this author , Thomas SteuberThomas Steuber More articles by this author , Markus GraefenMarkus Graefen More articles by this author , and Derya TilkiDerya Tilki More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556399.09410.aeAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Several definitions of high-risk prostate cancer (PCa) exist. We examined the impact of different pre-treatment definitions on metastasis-free survival (MFS), cancer-specific mortality (CSM) and overall mortality (OM) after radical prostatectomy (RP). METHODS: For this, 27,996 patients with clinically localized disease who underwent RP at a single institution between 1992 and 2018 were retrospectively analysed. Six pre-treatment definitions of high-risk PCa (prostate-specific antigen [PSA] ≥20 ng/ml, biopsy Gleason score [GS] 8- 10, clinical stage ≥T2c, clinical stage T3 [cT3], D'Amico definition, National Comprehensive Cancer Network [NCCN] definition) were evaluated. Kaplan-Meier as well as multivariable Cox regression analyses were used to compare outcomes between the groups. RESULTS: Depending on the definition, patients with high-risk PCa comprised between 0.9% (when using cT3 as the criterion) and 20.4% (when using the D'Amico criterion) of the population. Median follow-up was 60.9 months. 10-year metastasis-free survival rates ranged from 78.9% (PSA ≥20 ng/ml) to 66.5% (Gleason 8-10). 10-year cancer-specific survival rates varied from 94.6 (PSA ≥20 ng/ml) to 86.6% (cT3). 10-year overall survival rates ranged from 87.1 (NCCN high risk) to 79.3% (≥cT2c). On multivariable analysis, all high-risk definitions were associated with a higher risk of metastasis compared to lower risk groups (hazard ratio [HR] between 3.3 for ≥cT2c and 9.5 for Gleason 8-10; all p < 0.001). All high-risk definitions were associated with a higher risk of CSM compared to lower risk groups (HR between 3.4 for PSA ≥20 ng/ml and 6.4 for cT3; all p < 0.001). All definitions of high risk were associated with a higher risk of OM (HR between 2.0 for PSA ≥20 ng/ml to 2.4 for ≥cT2c; all p < 0.01). CONCLUSIONS: Variety in outcomes exist, depending on the pre-treatment definition of high-risk PC. Among the tested, Gleason 8-10 was the strongest predictor for higher risk of metastasis, cT3 was the strongest predictor for higher risk of CSM and OM. Source of Funding: None Hamburg, Germany; Montréal, Canada; Hamburg, Germany© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e738-e738 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sophie Knipper* More articles by this author Pierre Karakiewicz More articles by this author Thomas Steuber More articles by this author Markus Graefen More articles by this author Derya Tilki More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».