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Basic Research

The effect of race on the discriminatory accuracy of models to predict biochemical recurrence after radical prostatectomy: results from the Shared Equal Access Regional Cancer Hospital and Duke Prostate Center databases

Prostate Cancer and Prostatic Diseases volume 13, pages 87–93 (2010)Cite this article

Abstract

To evaluate whether race modifies the accuracy of nomograms to predict biochemical recurrence (BCR) after radical prostatectomy among subjects from the Shared Equal Access Regional Cancer Hospital (SEARCH) and Duke Prostate Center (DPC) databases. Retrospective analysis of 1721 and 4511 subjects from the SEARCH and DPC cohorts, respectively. The discrimination accuracy for BCR of seven previously published predictive models was assessed using concordance index and compared between African-American men (AAM) and Caucasian men (CM). AAM represented 44% of SEARCH and 14% of DPC. In both cohorts, AAM were more likely to experience BCR than CM (P<0.01). In SEARCH, the mean concordance index across all seven models was lower in AAM (0.678) than CM (0.715), though the mean difference between CM and AAM was modest (0.037; range 0.015–0.062). In DPC the overall mean concordance index for BCR across all seven nomograms was 0.686. In contrast to SEARCH, the mean concordance index in DPC was higher in AAM (0.717) than CM (0.681), though the mean differences between CM and AAM was modest (−0.036; range −0.078 to −0.004). Across all seven models for predicting BCR, the discriminatory accuracy was better among CM in SEARCH and better among AAM in DPC. The mean difference in discriminatory accuracy of all seven nomograms between AAM and CM was approximately 3–4%. This indicates that currently used predictive models have similar performances among CM and AAM. Therefore, nomograms represent a valid and accurate method to predict BCR regardless of race.

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Acknowledgements

Department of Veterans Affairs, National Institute of Health R01CA100938 (WJA), NIH Specialized Programs of Research Excellence Grant P50 CA92131-01A1 (WJA), the Georgia Cancer Coalition (MKT), the Department of Defense, Prostate Cancer Research Program, (SJF), and the American Urological Association Foundation/Astellas Rising Star in Urology Award (SJF). Views and opinions of, and endorsements by the author(s) do not reflect those of the US Army or the Department of Defense.

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Authors and Affiliations

  1. Division of Urologic Surgery, Department of Surgery, and the Duke Prostate Center, Duke University School of Medicine, Durham, NC, USA

    D M Moreira, L L Sun, J W Moul & S J Freedland

  2. Urology Section, Veterans Affairs Medical Center Durham, Durham, NC, USA

    D M Moreira & S J Freedland

  3. Department of Urology, Stanford University Medical Center, Stanford, CA, USA

    J C Presti Jr

  4. Department of Surgery, Urology Section, Veterans Affairs Medical Center, Palo Alto, CA, USA

    J C Presti Jr

  5. Department of Surgery, Urology Section, Veterans Affairs Medical Center, Greater Los Angeles, Los Angeles, CA, USA

    W J Aronson

  6. Department of Urology, University of California at Los Angeles Medical Center, Los Angeles, CA, USA

    W J Aronson

  7. Division of Surgery, Veterans Affairs Medical Centers and Division of Urologic Surgery, Department of Surgery, Urology Section, Medical College of Georgia, Augusta, Georgia

    M K Terris

  8. Division of Urology, Department of Surgery, University of California at San Diego Medical Center, San Diego, CA, USA

    C J Kane

  9. Division of Urology, Department of Surgery, Oregon Health & Science University, Portland, Oregon, USA

    C L Amling

  10. Department of Pathology, Duke University School of Medicine, Durham, NC, USA

    S J Freedland

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  1. D M Moreira
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Correspondence to D M Moreira.

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Moreira, D., Presti, J., Aronson, W. et al. The effect of race on the discriminatory accuracy of models to predict biochemical recurrence after radical prostatectomy: results from the Shared Equal Access Regional Cancer Hospital and Duke Prostate Center databases. Prostate Cancer Prostatic Dis 13, 87–93 (2010). https://doi.org/10.1038/pcan.2009.48

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