Review

Tools for predicting patient-reported outcomes in prostate cancer patients undergoing radical prostatectomy: a systematic review of prognostic accuracy and validity

  • Prostate Cancer and Prostatic Diseases volume 20, pages 378388 (2017)
  • doi:10.1038/pcan.2017.28
  • Download Citation
Received:
Revised:
Accepted:
Published online:

Abstract

Background:

Radical prostatectomy is a common surgical procedure performed to treat prostate cancer. Patient-reported outcomes after surgery include urinary incontinence, erectile dysfunction, decreased quality of life and psychological effects. Predictive tools to assess the likelihood of an individual experiencing various patient-reported outcomes have been developed to aid decision-making when selecting treatment.

Methods:

A systematic review was undertaken to identify all papers describing tools for the prediction of patient-reported outcome measures in men with prostate cancer treated with radical prostatectomy. To be eligible for inclusion, papers had to provide a summary measure of accuracy. PubMed and EMBASE were searched from July 2007. Title/abstract screening, and full-text review were undertaken by two reviewers, while data extraction and critical appraisal was performed by a single reviewer.

Results:

The search strategy identified 3217 potential studies, of which 191 progressed to full-text review and 14 were included. From these studies, 27 tools in total were identified, of which 18 predicted urinary symptoms, six predicted erectile function and one predicted freedom from a group of three outcomes (‘trifecta’) (biochemical recurrence, incontinence and erectile dysfunction). On the basis of tool accuracy (>70%) and external validation, two tools predicting incontinence and two tools predicting erectile dysfunction are ready for implementation.

Conclusions:

A small number of tools for the prediction of patient-reported outcomes following radical prostatectomy have been developed. Four tools were found to have adequate accuracy and validation and are ready for implementation for the prediction of urinary incontinence and erectile dysfunction.

  • Subscribe to Prostate Cancer and Prostatic Diseases for full access:

    $444

    Subscribe

Additional access options:

Already a subscriber?  Log in  now or  Register  for online access.

References

  1. 1.

    Global Burden of Disease Cancer C, , , , , et al. The Global Burden of Cancer 2013. JAMA Oncol 2015; 1: 505–527.

  2. 2.

    , , , , , et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015; 136: E359–E386.

  3. 3.

    Australian Institute of Health and Welfare (AIHW)Australian Cancer Incidence and Mortality (ACIM) books: Prostate cancer. AIHW AIHW: Canberra, Australia, 2016.

  4. 4.

    , , , , , et al. A competing-risks analysis of survival after alternative treatment modalities for prostate cancer patients: 1988-2006. Eur Urol 2011; 59: 88–95.

  5. 5.

    , , , , , et al. Hospital complication rates with bariatric surgery in Michigan. JAMA 2010; 304: 435–442.

  6. 6.

    , , , , , et al. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 1998; 280: 969–974.

  7. 7.

    , , , , , et al. Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. JAMA 2000; 283: 354–360.

  8. 8.

    , , , , . Factors predicting recovery of erections after radical prostatectomy. J Urol 2000; 164: 1929–1934.

  9. 9.

    , , , , . Factors affecting erectile function after radical retropubic prostatectomy: results from 1620 consecutive patients. BJU Int 2008; 101: 833–836.

  10. 10.

    , , , , , . Potency, continence and complications in 3,477 consecutive radical retropubic prostatectomies. J Urol 2004; 172 (6 Pt 1): 2227–2231.

  11. 11.

    , , . Predicting an optimal outcome after radical prostatectomy: the trifecta nomogram. J Urol 2008; 179: 2207–2210; discussion2210-2201.

  12. 12.

    , , . Age difference between patient and partner is a predictive factor of potency rate following radical prostatectomy. J Urol 2006; 176 (6 Pt 1): 2594–2598; discussion 2598.

  13. 13.

    , , , , , . Prediction of postoperative sexual function after nerve sparing radical retropubic prostatectomy. J Urol 2006; 176: 227–231.

  14. 14.

    , , , , . Erectile function recovery rate after radical prostatectomy: a meta-analysis. J Sex Med 2009; 6: 2538–2546.

  15. 15.

    , , , , . Clinicians versus nomogram: predicting future technetium-99m bone scan positivity in patients with rising prostate-specific antigen after radical prostatectomy for prostate cancer. Urology 2013; 81: 956–961.

  16. 16.

    , , , , , et al. Clinicians are poor raters of life-expectancy before radical prostatectomy or definitive radiotherapy for localized prostate cancer. BJU Int 2007; 100: 1254–1258.

  17. 17.

    , . What do we mean by validating a prognostic model? Stat Med 2000; 19: 453–473.

  18. 18.

    , . External validation of a Cox prognostic model: principles and methods. BMC Med Res Methodol 2013; 13: 33.

  19. 19.

    , , , . An updated catalog of prostate cancer predictive tools. Cancer 2008; 113: 3075–3099.

  20. 20.

    , , , , , et al. Development of an International Prostate Cancer Outcomes Registry. BJU Int 2016; 117 (Suppl 4): 60–67.

  21. 21.

    Centre for Evidence Based MedicineCritical Appraisal of Prognostic Studies. : University of Oxford: Oxford, UK, 2016.

  22. 22.

    , , , , , et al. Prospective urodynamic model for prediction of urinary incontinence after robot-assisted radical prostatectomy. Urol Int 2014; 92: 306–309.

  23. 23.

    , , , , , et al. Prediction of functional outcomes after nerve-sparing radical prostatectomy: results of conditional survival analyses. Eur Urol 2012; 62: 42–52.

  24. 24.

    , , , , . Development of clinical models for predicting erectile function after localized prostate cancer treatment. Int J Urol 2014; 21: 1227–1233.

  25. 25.

    , , , , , et al. A novel tool to assess the risk of urinary incontinence after nerve-sparing radical prostatectomy. BJU Int 2013; 111: 905–913.

  26. 26.

    , , , , , et al. Predicting erectile function recovery after bilateral nerve sparing radical prostatectomy: a proposal of a novel preoperative risk stratification. J Sex Med 2010; 7: 2521–2531.

  27. 27.

    , , , , , et al. Preoperative criteria to select patients for bilateral nerve-sparing robotic-assisted radical prostatectomy. J Sex Med 2010; 7 (2 Pt 1): 839–845.

  28. 28.

    , , , , . Striated muscle in the prostatic apex: does the amount in radical prostatectomy specimens predict postprostatectomy urinary incontinence? Urology 2014; 83: 888–892.

  29. 29.

    , , , , , et al. Prediction of erectile function following treatment for prostate cancer. JAMA 2011; 306: 1205–1214.

  30. 30.

    , , , , , et al. Preoperative predictive model of recovery of urinary continence after radical prostatectomy. BJU Int 2015; 116: 577–583.

  31. 31.

    , , , , , et al. Recovery of urinary function after radical prostatectomy; Predictors of urinary function on preoperative prostate magnetic resonance imaging. J Urol 2011; 185: e195.

  32. 32.

    , , , , , et al. Comprehensive prediction model of urinary incontinence one year following robot-assisted radical prostatectomy. Urol Int 2013; 90: 31–35.

  33. 33.

    , , , , , . MRI factors to predict urinary incontinence after retropubic/laparoscopic radical prostatectomy. Int Urol Nephrol 2015; 47: 1343–1349.

  34. 34.

    , , , , , et al. Development and validation of nomograms to predict the recovery of urinary continence after radical prostatectomy: comparisons between immediate, early, and late continence. World J Urol 2014; 32: 437–444.

  35. 35.

    , , , . Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD): the TRIPOD statement. Ann Intern Med 2015; 162: 55–63.

  36. 36.

    , , , , , et al. Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD): explanation and elaboration. Ann Intern Med 2015; 162: W1–73.

  37. 37.

    , , , . Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD): the TRIPOD statement. Br J Cancer 2015; 112: 251–259.

  38. 38.

    , , , . Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD): the TRIPOD Statement. BMC Med 2015; 13: 1.

  39. 39.

    , , , . Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD): the TRIPOD statement. BMJ 2015; 350: g7594.

  40. 40.

    , , , . members of Tg. Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD): the TRIPOD Statement. Eur Urol 2015; 67: 1142–1151.

  41. 41.

    , , , . Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD): the TRIPOD Statement. Br J Surg 2015; 102: 148–158.

  42. 42.

    , , , . Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD). Ann Intern Med 2015; 162: 735–736.

  43. 43.

    , , , . New Guideline for the reporting of studies developing, validating, or updating a multivariable clinical prediction model: the TRIPOD Statement. Adv Anat Pathol 2015; 22: 303–305.

Download references

Acknowledgements

This project was funded by the Movember Foundation as part of the Prostate Cancer Health Outcomes Research Unit.

Author information

Affiliations

  1. Urology Unit, SA Health, Repatriation General Hospital, Adelaide, SA, Australia

    • M E O'Callaghan
    •  & E Raymond
  2. South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC), Adelaide, SA, Australia

    • M E O'Callaghan
    • , E Raymond
    • , K Beckmann
    • , M Borg
    •  & K Moretti
  3. Flinders Centre for Innovation in Cancer, Adelaide, SA, Australia

    • M E O'Callaghan
    •  & K Moretti
  4. Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, SA, Australia

    • M E O'Callaghan
    • , A D Vincent
    •  & K Moretti
  5. Joanna Briggs Institute, University of Adelaide, Adelaide, SA, Australia

    • J Campbell
  6. Centre for Population Health Research, University of South Australia, Adelaide, SA, Australia

    • K Beckmann
    • , D Roder
    •  & K Moretti
  7. Department of Epidemiology & Preventative Medicine, Monash University, Melbourne, VIC, Australia

    • S Evans
    • , J McNeil
    •  & J Zalcberg
  8. Department of Radiation Oncology, Alfred Health, Melbourne, VIC, Australia

    • J Millar
  9. Adelaide Radiotherapy Centre, Adelaide, SA, Australia

    • M Borg
  10. Discipline of Surgery, University of Adelaide, Adelaide, SA, Australia

    • K Moretti

Authors

  1. Search for M E O'Callaghan in:

  2. Search for E Raymond in:

  3. Search for J Campbell in:

  4. Search for A D Vincent in:

  5. Search for K Beckmann in:

  6. Search for D Roder in:

  7. Search for S Evans in:

  8. Search for J McNeil in:

  9. Search for J Millar in:

  10. Search for J Zalcberg in:

  11. Search for M Borg in:

  12. Search for K Moretti in:

Competing interests

The authors declare no conflict of interest.

Corresponding author

Correspondence to M E O'Callaghan.

Supplementary information

Supplementary Information accompanies the paper on the Prostate Cancer and Prostatic Diseases website (http://www.nature.com/pcan)