A catalog of prostate cancer nomograms

Abstract

Purpose: Prediction is central to the management of prostate cancer. Nomograms are devices that make predictions. We organized many nomograms for prostate cancer. Materials and Methods: Using MEDLINE a literature search was performed on prostate cancer nomograms from January 1966 to February 2000. We recorded input variables, prediction form, the number of patients used to develop the nomogram and the outcome being predicted. We also recorded the accuracy measures reported by the original authors and whether the nomograms have withstood validation. In addition, we noted whether the nomograms were proprietary or in the public domain. Each nomogram was classified into patient clinical disease state and the outcome being predicted. Results: The literature search generated 42 published nomograms that may be applied to patients in various clinical stages of disease. Of the 42 nomograms only 18 had undergone validation, of which 2 partially failed. Few nomograms have been compared for predictive superiority and none appears to have been compared with clinical judgment alone. Conclusions: Patients with prostate cancer need accurate predictions. Prognostic nomograms are available for many clinical states and outcomes, and may provide the most accurate predictions currently available. Selection among them and progress in this field are hampered by the lack of comparisons for predictive accuracy.