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Validation in CaPSURE of Predicted Sexual Outcome after Primary Prostate Cancer Treatment by PROSTQA
Mehrdad Alemozaffar1, Meredith A Regan2, Natalia Sadetsky3, Peter Carroll3, Martin G Sanda1, Matt Cooperberg3
1Beth Israel Deaconess Medical Center, boston, MA;2Dana Farber Cancer Institute, boston, MA;3University of California San Francisco, San Francisco, CA
Patients with localized prostate cancer undergoing radical prostatectomy (RP), external radiation therapy (XRT), or brachytherapy (BT) are often concerned about erectile function (EF) following treatment. We developed models for individualized sexual outcome expectations following prostate cancer treatment at academic centers and sought to validate them in a community-based cohort.
The PROSTQA cohort was utilized to create models predicting the likelihood of EF at 2 years following therapy for localized prostate cancer with RP, XRT, or BT (N=1027), based on pre-treatment patient, disease, treatment and HRQOL characteristics.
CaPSURE participants (N=1931), were used for validation by AUC from fitting univariable logistic regression of reported 2-year EF on model-predicted probability, and calibration by examining model-predicted probability vs. observed EF at 2 years.
The PROSTQA models performed well in predicting EF at 2-years following treatment with AUC's of 0.76, 0.81, and 0.89 for men undergoing RP, XRT, and BT, respectively. Calibration showed that predicted rates of EF based on the PROSTQA-derived models corresponded to the observed outcome in the CaPSURE cohort across a broad range of predicted probabilities. (Table 1)
Validation in a community-based cohort of predictive models for recovery of EF following treatment of localized prostate cancer with RP, XRT, and BT at academic centers based on pretreatment EF and various patient and treatment characteristics suggest that these models are generalizable.
Table 1. PROSTQA Outcomes and Observed CaPSURE Erectile Function recovery at 2 years
|Mean PROSTQA-estimated 2yr erectile recovery
|Observed proportion 2yr erectile recovery in CaPSURE
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