PD40-02 ONCOLOGIC OUTCOMES AFTER RADICAL PROSTATECTOMY FOR HIGH RISK PROSTATE CANCER: IMPACT OF VARIOUS DEFINITIONS ON CANCER-SPECIFIC AND OVERALL MORTALITY
Bibliographic record
Abstract
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 ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".