Seminars in urologic oncology最新文献_第3页

Nomograms and instruments for the initial prostate evaluation: the ability to estimate the likelihood of identifying prostate cancer. 用于前列腺初步评估的图和仪器:评估前列腺癌的可能性的能力。

Seminars in urologic oncology Pub Date : 2002-05-01 DOI: 10.1053/SURO.2002.32520

M. Ohori, P. Swindle

{"title":"Nomograms and instruments for the initial prostate evaluation: the ability to estimate the likelihood of identifying prostate cancer.","authors":"M. Ohori, P. Swindle","doi":"10.1053/SURO.2002.32520","DOIUrl":"https://doi.org/10.1053/SURO.2002.32520","url":null,"abstract":"As a result of prostate cancer screening programs, approximately 10% of otherwise healthy men will be found to have an elevated prostate-specific antigen (PSA) level and therefore be at risk for harboring prostate cancer. Patients with an elevated PSA level have a wide variation in the risk for having prostate cancer diagnosed by transrectal ultrasound (TRUS)-guided prostate biopsy. To adequately counsel these patients, some form of individualized risk assessment must be given. There are several tables, artificial neural network (ANN) models, and nomograms that are available to stratify an individual patients risk for having prostate cancer diagnosed by a TRUS biopsy, either initially or on subsequent biopsies after a previous negative biopsy. Presently, nomograms are also being developed to predict the risk not only for having prostate cancer but also for clinically significant prostate cancer. The difficulty in calculating this risk for an individual patient is that the multiple competing clinical and pathologic factors have varying degrees of effect on the overall risk. This problem of competing risk factors can be overcome by the use of nomograms or ANNs. This article reviews the available instruments that are available to the urologist to enable prediction of the risk for having prostate cancer diagnosed by TRUS-guided prostate biopsy.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 2 1","pages":"116-22"},"PeriodicalIF":0.0,"publicationDate":"2002-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58398663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 17

Nomograms for clinically localized prostate cancer. Part I: radical prostatectomy. 临床局限性前列腺癌的影像学检查。第一部分:根治性前列腺切除术。

Seminars in urologic oncology Pub Date : 2002-05-01 DOI: 10.1053/SURO.2002.32493

Misop Han, A. Partin

引用次数: 15

Comparisons of nomograms and urologists' predictions in prostate cancer. 前列腺癌的造影图与泌尿科医师预测的比较。

Seminars in urologic oncology Pub Date : 2002-05-01 DOI: 10.1053/SURO.2002.32490

P. Ross, C. Gerigk, M. Gonen, O. Yossepowitch, I. Cagiannos, P. Sogani, P. Scardino, M. Kattan

{"title":"Comparisons of nomograms and urologists' predictions in prostate cancer.","authors":"P. Ross, C. Gerigk, M. Gonen, O. Yossepowitch, I. Cagiannos, P. Sogani, P. Scardino, M. Kattan","doi":"10.1053/SURO.2002.32490","DOIUrl":"https://doi.org/10.1053/SURO.2002.32490","url":null,"abstract":"When applying nomograms to a clinical setting it is essential to know how their predictions compare with clinicians'. Comparisons exist outside of the prostate cancer literature. We reviewed these comparisons and conducted 2 experiments comparing predictions of clinicians with prostate cancer nomograms. By using Medline, we searched studies from January 1966 to July 1999 that compared human predictions with nomogram predictions. Next, we conducted 2 experiments: (1) 17 urologists were presented with 10 case vignettes and asked to predict the 5-year recurrence-free probabilities for each patient; (2) case presentations of 63 prostate cancer patients (including full clinical histories with complete diagnostic data and surgical findings) were made to a group of 25 clinicians who were asked to predict organ-confined disease. We found 22 published studies comparing human experts with nomograms, greater than half (13 of 22) showed the nomogram performing above the level of the human expert. Our first experiment showed urologist modification of 165 nomogram predictions led to a decrease in prediction accuracy (c-index decreased from.67 to.55, P <.05). In our second experiment, clinician predictions of organ-confined disease were comparable to the nomogram (area under the receiver operating characteristic curve [AUC] 0.78 and 0.79, respectively). A mixed-model suggests the nomogram did not augment clinician prediction accuracy (doctor excess error 1.4%, P =.75, 95% confidence interval [CI]: -10.9% to 8.2%). Our data suggest that nomograms do not seem to diminish predictive accuracy and they may be of significant benefit in certain clinical decision making settings.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 2 1","pages":"82-8"},"PeriodicalIF":0.0,"publicationDate":"2002-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58398322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 235

Nomograms for clinically localized prostate cancer. Part II: radiation therapy. 临床局限性前列腺癌的影像学检查。第二部分:放射治疗。

Seminars in urologic oncology Pub Date : 2002-05-01 DOI: 10.1053/SURO.2002.32494

L. Potters

{"title":"Nomograms for clinically localized prostate cancer. Part II: radiation therapy.","authors":"L. Potters","doi":"10.1053/SURO.2002.32494","DOIUrl":"https://doi.org/10.1053/SURO.2002.32494","url":null,"abstract":"Prostate cancer can be effectively treated with either external beam radiation techniques or with brachytherapy. This study was designed to address the methodology that is used to assess outcome data in the current radiation literature and to evaluate available nomograms that can be used to predict outcomes. A literature search was performed and 12 articles reviewed. Risk stratification was the most frequently used methodology to analyze data. This method encompasses disease-specific variables: the pretreatment prostate-specific antigen (PSA) value and the Gleason score are classified by using cut points into low, intermediate, and high-risk groups. Another methodology uses nomograms to predict outcome. The nomogram uses continuous values of each variable so that the outcome probability for a specific set of parameters is quite specific. The advantage of nomogram analysis over risk stratification analysis is presented. In conclusion, only 3 reports were identified in the radiation literature that used a nomogram to predict outcome. One of the nomograms is proprietary and difficult to interpret. The other 2 nomograms, 1 for 3-dimensional radiation and the other for brachytherapy, have been incorporated into hand-held devices that can be used at consultation with the patient to discuss outcome probabilities to assist in treatment decisions.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 2 1","pages":"131-9"},"PeriodicalIF":0.0,"publicationDate":"2002-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58398125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Nomograms as predictive models. 作为预测模型的nomogram。

Seminars in urologic oncology Pub Date : 2002-05-01 DOI: 10.1053/SURO.2002.32936

J. Eastham, M. Kattan, P. Scardino

引用次数: 86

Nomograms for clinically localized disease. Part III: watchful waiting. 临床局限性疾病的x线图。第三部分:警惕等待。

Seminars in urologic oncology Pub Date : 2002-05-01 DOI: 10.1053/SURO.2002.32495

E. Schwartz, P. Albertsen

引用次数: 10

Outcome predictions for patients with metastatic prostate cancer. 转移性前列腺癌患者预后预测。

Seminars in urologic oncology Pub Date : 2002-05-01 DOI: 10.1053/SURO.2002.32938

O. Smaletz, H. Scher

引用次数: 20

Web resources for patients with prostate cancer: a starting point. 前列腺癌患者的网络资源:一个起点。

Seminars in urologic oncology Pub Date : 2002-02-01 DOI: 10.1053/SURO.2002.30396

Emily R Lipp

引用次数: 16

Treatment outcomes in localized prostate cancer: a patient-oriented approach. 局部前列腺癌的治疗结果:以患者为导向的方法。

Seminars in urologic oncology Pub Date : 2002-02-01 DOI: 10.1053/SURO.2002.30400

R. Lee, D. Penson

{"title":"Treatment outcomes in localized prostate cancer: a patient-oriented approach.","authors":"R. Lee, D. Penson","doi":"10.1053/SURO.2002.30400","DOIUrl":"https://doi.org/10.1053/SURO.2002.30400","url":null,"abstract":"Although there are many treatment options available to patients with localized prostate cancer, it remains unclear which is superior in terms of overall survival. Patients, therefore, consider a number of other less traditional outcomes when choosing therapy for newly diagnosed disease. In particular, because each treatment can have a unique and highly individual impact on various aspects of the patient's health and daily life, there is a need for a patient-oriented approach to outcomes that accounts for both quantity and quality of life after therapy. Although all therapies can result in some degree of sexual, urinary, or bowel dysfunction, the degree of bother patients experience does not always correlate with the objective degree of symptoms present. Providers must, therefore, make the important distinction between function and bother when presenting the risks for each therapy to patients. Patients should also be aware that if they experience particular bother from their sexual or urinary dysfunction, there are therapies available that will improve erectile function or lower urinary tract voiding dysfunction and result in better quality of life. Finally, when discussing the probability of unwanted outcomes, such as urinary, sexual, or bowel dysfunction after treatment for localized prostate cancer, providers should strive to present risks by using a number of different styles, facilitating understanding, and leading to a truly informed decision that best fits the patient's goals.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 1 1","pages":"63-73"},"PeriodicalIF":0.0,"publicationDate":"2002-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58398212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 15

Prostate biopsy techniques and indications: when, where, and how? 前列腺活检技术和适应症:何时、何地、如何活检?

Seminars in urologic oncology Pub Date : 2002-02-01 DOI: 10.1053/SURO.2002.30395

D. Scherr, J. Eastham, M. Ohori, P. Scardino

{"title":"Prostate biopsy techniques and indications: when, where, and how?","authors":"D. Scherr, J. Eastham, M. Ohori, P. Scardino","doi":"10.1053/SURO.2002.30395","DOIUrl":"https://doi.org/10.1053/SURO.2002.30395","url":null,"abstract":"Transrectal ultrasound (TRUS) and prostate biopsy have become one of the most common office-based procedures for the practicing urologist. During the past 50 years, the techniques, indications, and pathologic interpretation of prostate biopsies have evolved. The abandonment of blind finger-guided needle biopsies in favor of systematic TRUS-guided biopsies epitomizes much of this change. Similarly, the indications for prostate biopsy have become more refined. In the past, the presence of a prostatic nodule on digital rectal examination (DRE) was the primary indication for biopsy until the introduction of prostatic-specific antigen (PSA) in the 1980s and its widespread use for prostate cancer screening. Abnormalities of PSA or its derivatives now represent the most common indication for prostate biopsy. Although TRUS initially began as a tool to direct needles into various locations within the prostate, today a great deal of information can be obtained from prostate ultrasound for the discerning clinician. As such, TRUS-guided biopsy of the prostate has become an important staging and diagnostic tool for the practicing urologist. Here we review the current techniques and indications as well as pertinent pathologic and staging data obtained through TRUS and prostate biopsy.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 1 1","pages":"18-31"},"PeriodicalIF":0.0,"publicationDate":"2002-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58397634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 34