Prognostic Factors for Survival in Noncastrate Metastatic Prostate Cancer: Validation of the Glass Model and Development of a Novel Simplified Prognostic Model - Inserm - Institut national de la santé et de la recherche médicale Access content directly
Journal Articles European Urology Year : 2015

Prognostic Factors for Survival in Noncastrate Metastatic Prostate Cancer: Validation of the Glass Model and Development of a Novel Simplified Prognostic Model

1 IPC - Institut Paoli-Calmettes
2 SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
3 IGR - Institut Gustave Roussy
4 UP11 - Université Paris-Sud - Paris 11
5 Oncologie génito-urinaire
6 UNICANCER/CRLC - Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
7 Hôpital Côte de Nacre [CHU Caen]
8 CHD Vendée - Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon
9 Clinique Pasteur [Toulouse]
10 CRLCC Paul Papin - CRLCC - Centre Paul Papin
11 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
12 CRLCC - CRLCC Eugène Marquis
13 CRLCC René Gauducheau
14 Hôpital Foch [Suresnes]
15 Centre hospitalier Saint-Joseph [Paris]
16 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
17 CRLC Val d'Aurelle-Paul Lamarque
18 Institut Claudius Regaud
19 Institut Curie [Paris]
20 UNICANCER/CRLCC-CGFL - Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon]
21 UNICANCER
22 HTH-SM - Hôpital de Toulon/Hyères - Sainte Marguerite [Hyères]
23 Centre Hospitalier Layné
24 TIMONE - Hôpital de la Timone [CHU - APHM]
25 CHR Metz-Thionville - Centre hospitalier régional Metz-Thionville
26 Hôpital Bretonneau
27 Hôpital Dupuytren [CHU Limoges]
28 UCL - Université Catholique de Louvain = Catholic University of Louvain
29 CCS - Centre Catherine-de-Sienne [Nantes]
30 Hôpital Saint-André
31 CSJL - Clinique Saint-Jean Languedoc [Toulouse]
32 Institut Jean Godinot [Reims]
33 Clinique Armoricaine de Radiologie [St. Brieuc]
34 AP-HP - Hopital Saint-Louis [AP-HP]
35 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
36 HEGP - Hôpital Européen Georges Pompidou [APHP]
37 UPD5 - Université Paris Descartes - Paris 5
Gwenaelle Gravis
Muriel Habibian
  • Function : Author
Alain Ravaud

Abstract

Background: The Glass model developed in 2003 uses prognostic factors for noncastrate metastatic prostate cancer (NCMPC) to define subgroups with good, intermediate, and poor prognosis. Objective: To validate NCMPC risk groups in a more recently diagnosed population and to develop a more sensitive prognostic model. Design, setting, and participants: NCMPC patients were randomized to receive continuous androgen deprivation therapy (ADT) with or without docetaxel in the GETUG-15 phase 3 trial. Potential prognostic factors were recorded: age, performance status, Gleason score, hemoglobin (Hb), prostate-specific antigen, alkaline phosphatase (ALP), lactate dehydrogenase (LDH), metastatic localization, body mass index, and pain. Outcome measurements and statistical analysis: These factors were used to develop a new prognostic model using a recursive partitioning method. Before analysis, the data were split into learning and validation sets. The outcome was overall survival (OS). Results and limitations: For the 385 patients included, those with good (49%), intermediate (29%), and poor (22%) prognosis had median OS of 69.0, 46.5 and 36.6 mo (p=0.001), and 5-yr survival estimates of 60.7%, 39.4%, and 32.1%, respectively (p=0.001). The most discriminatory variables in univariate analysis were ALP, pain intensity, Hb, LDH, and bone metastases. ALP was the strongest prognostic factor in discriminating patients with good or poor prognosis. In the learning set, median OS in patients with normal and abnormal ALP was 69.1 and 33.6 mo, and 5-yr survival estimates were 62.1% and 23.2%, respectively. The hazard ratio for ALP was 3.11 and 3.13 in the learning and validation sets, respectively. The discriminatory ability of ALP (concordance [C] index 0.64, 95% confidence interval [CI] 0.58-0.71) was superior to that of the Glass risk model (C-index 0.59, 95% CI 0.52-0.66). The study limitations include the limited number of patients and low values for the C-index. Conclusion: A new and simple prognostic model was developed for patients with NCMPC, underlying the role of normal or abnormal ALP.
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Dates and versions

inserm-03353959 , version 1 (24-09-2021)

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Gwenaelle Gravis, Jean-Marie Boher, Karim Fizazi, Florence Joly, Franck Priou, et al.. Prognostic Factors for Survival in Noncastrate Metastatic Prostate Cancer: Validation of the Glass Model and Development of a Novel Simplified Prognostic Model. European Urology, 2015, 68 (2), pp.196 - 204. ⟨10.1016/j.eururo.2014.09.022⟩. ⟨inserm-03353959⟩
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