Prognostic Index for Predicting Prostate Cancer Survival in a Randomized Screening Trial: Development and Validation

S Neupane, J Nevalainen, J Raitanen, K Talala, P Kujala, K Taari, TL Tammela, Ewout Steyerberg, A Auvinen

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We developed and validated a prognostic index to predict survival from prostate cancer (PCa) based on the Finnish randomized screening trial (FinRSPC). Men diagnosed with localized PCa (N = 7042) were included. European Association of Urology risk groups were defined. The follow-up was divided into three periods (0–3, 3–9 and 9–20 years) for development and two corresponding validation periods (3–6 and 9–15 years). A multivariable complementary log–log regression model was used to calculate the full prognostic index. Predicted cause-specific survival at 10 years from diagnosis was calculated for the control arm using a simplified risk score at diagnosis. The full prognostic index discriminates well men with PCa with different survival. The area under the curve (AUC) was 0.83 for both the 3–6 year and 9–15 year validation periods. In the simplified risk score, patients with a low risk score at diagnosis had the most favorable survival, while the outcome was poorest for the patients with high risk scores. The prognostic index was able to distinguish well between men with higher and lower survival, and the simplified risk score can be used as a basis for decision making.

Original languageEnglish
Article number435
Pages (from-to)1-13
Number of pages13
Issue number3
Publication statusPublished - 24 Jan 2021

Bibliographical note

Funding Information:
This study was funded in part by competitive state research funding administered by Expert Responsibility area of Tampere University Hospital, grants 9N064 and 9R002, the Finnish Academy (grant number #260931), and the Cancer Society of Finland grant to Prof. Anssi Auvinen.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

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