Prediction models of incontinence and sexual function one year after radical prostatectomy based on data from 20 164 prostate cancer patients

被引：2

作者：

Sibert, Nora Tabea ^{[1
]}

Kurth, Tobias ^{[2
]}

Breidenbach, Clara ^{[1
]}

Wesselmann, Simone ^{[1
]}

Feick, Guenther ^{[3
]}

Carl, Ernst-Guenter ^{[3
]}

Dieng, Sebastian ^{[4
]}

Albarghouth, Mohamad Hatem ^{[5
]}

Aziz, Atiqullah ^{[6
]}

Baltes, Stefan ^{[7
]}

Bartolf, Elisabeth ^{[8
]}

Bedke, Jens ^{[9
]}

Blana, Andreas ^{[10
]}

Brock, Marko ^{[11
]}

Conrad, Stefan ^{[12
]}

Darr, Christopher ^{[13
]}

Distler, Florian ^{[14
]}

Drosos, Konstantinos ^{[15
]}

Duwe, Gregor ^{[16
]}

Gaber, Amr ^{[17
]}

Giessing, Markus ^{[18
]}

Harke, Nina Natascha ^{[19
]}

Heidenreich, Axel ^{[20
]}

Hijazi, Sameh ^{[21
]}

Hinkel, Andreas ^{[22
]}

Kaftan, Bjoern Theodor ^{[23
]}

Kheiderov, Shatlyk ^{[24
]}

Knoll, Thomas ^{[25
]}

Luemmen, Gerd ^{[26
]}

Peters, Inga ^{[27
]}

Polat, Buelent ^{[28
]}

Schrodi, Valentin ^{[29
]}

Stolzenburg, Jens-Uwe ^{[30
]}

Varga, Zoltan ^{[31
]}

von Suesskind-Schwendi, Julius ^{[32
]}

Zugor, Vahudin ^{[33
]}

Kowalski, Christoph ^{[1
]}

Attia, Sameh ^{[34
]}

机构：

[1] German Canc Soc DKG, Berlin, Germany

[2] Charite Univ Med Berlin, Inst Physiol, D-10117 Berlin, Germany

[3] Bundesverband Prostatakrebs Selbsthilfe, Bonn, Germany

[4] OnkoZert GmbH, Neu Ulm, Germany

[5] Sankt Georg Clin, Leipzig, Germany

[6] Munchen Klin Bogenhausen, Munich, Germany

[7] KRH Klinikum Siloah, Klinikum Reg Hannover, Hannover, Germany

[8] Ingolstadt Hosp, Dept Cardiol, Ingolstadt, Germany

[9] Univ Hosp Tubingen, Tubingen, Germany

[10] Klinikum Furth, Furth, Germany

[11] Ruhr Univ Bochum, Marien Hosp Herne, Dept Urol, Herne, Germany

[12] DIAKOVERE Friederikenstift, Hannover, Germany

[13] Univ Hosp Essen, Essen, Germany

[14] Klinikum Nurnberg, Nurnberg, Germany

[15] Univ Hosp Jena, Jena, Germany

[16] Univ Hosp Mainz, Mainz, Germany

[17] Carl Thiem Klinikum Cottbus, Inst Pathol, Cottbus, Germany

[18] Kliniken Maria Hilf, Monchengladbach, Germany

[19] Hannover Med Sch, Hannover, Germany

[20] Koln Univ Hosp, Cologne, Germany

[21] Klinikum Ibbenburen, Ibbenburen, Germany

[22] Franziskus Hosp Bielefeld, Bielefeld, Germany

[23] Gesundheitsholding Luneburg, Luneburg, Germany

[24] Johanniter Krankenhaus, Oberhausen, Germany

[25] Klinikum Sindelfingen Boblingen, Sindelfingen, Germany

[26] GFO Kliniken Troisdorf, Troisdorf, Germany

[27] Krankenhaus NW Frankfurt, Frankfurt, Germany

[28] Univ Hosp Wurzburg, Wurzburg, Germany

[29] Acad Hosp Braunschweig, Braunschweig, Germany

[30] Univ Leipzig, Neurol Clin, Leipzig, Germany

[31] SRH Kliniken Landkreis Sigmaringen, Sigmaringen, Germany

[32] Schwarzwald Baar Klinikum, Villingen Schwenningen, Germany

[33] Sozialstiftung Bamberg Hosp, Bamberg, Germany

[34] Justus Liebig Univ, Giessen, Germany

来源：

PLOS ONE | 2023年 / 18卷 / 12期

关键词：

QUALITY-OF-LIFE; REPORTED OUTCOMES; RADIATION-THERAPY; VALIDATION; SURGERY; URINARY;

D O I：

10.1371/journal.pone.0295179

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background Incontinence and sexual dysfunction are long-lasting side effects after surgical treatment (radical prostatectomy, RP) of prostate cancer (PC). For an informed treatment decision, physicians and patients should discuss expected impairments. Therefore, this paper firstly aims to develop and validate prognostic models that predict incontinence and sexual function of PC patients one year after RP and secondly to provide an online decision making tool.Methods Observational cohorts of PC patients treated between July 2016 and March 2021 in Germany were used. Models to predict functional outcomes one year after RP measured by the EPIC-26 questionnaire were developed using lasso regression, 80-20 splitting of the data set and 10-fold cross validation. To assess performance, R-2, RMSE, analysis of residuals and calibration-in-the-large were applied. Final models were externally temporally validated. Additionally, percentages of functional impairment (pad use for incontinence and firmness of erection for sexual score) per score decile were calculated to be used together with the prediction models.Results For model development and internal as well as external validation, samples of 11 355 and 8 809 patients were analysed. Results from the internal validation (incontinence: R-2 = 0.12, RMSE = 25.40, sexual function: R-2 = 0.23, RMSE = 21.44) were comparable with those of the external validation. Residual analysis and calibration-in-the-large showed good results. The prediction tool is freely accessible: https://nora-tabea.shinyapps.io/EPIC-26-Prediction/.Conclusion The final models showed appropriate predictive properties and can be used together with the calculated risks for specific functional impairments. Main strengths are the large study sample (> 20 000) and the inclusion of an external validation. The models incorporate meaningful and clinically available predictors ensuring an easy implementation. All predictions are displayed together with risks of frequent impairments such as pad use or erectile dysfunction such that the developed online tool provides a detailed and informative overview for clinicians as well as patients.

引用

页数：14

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