Penalized-Survival Nomogram Predicts 5-Year Metastasis-Free Survival After Salvage Radiotherapy for Postprostatectomy...

Area of Science:

• Oncology
• Radiation Oncology
• Urologic Oncology

Background:

• Salvage radiotherapy (SRT) is crucial for biochemical recurrence (BCR) post-radical prostatectomy (RP).
• A significant number of patients undergoing SRT still progress to distant metastasis.
• Predicting this progression is vital for patient management.

Purpose of the Study:

• To develop and validate a nomogram predicting 5-year distant-metastasis-free survival (DMFS) in patients receiving SRT.
• To identify key predictors of distant metastasis after SRT.
• To enable personalized risk stratification for improved patient outcomes.

Main Methods:

• Multicenter retrospective analysis of 1,720 patients undergoing SRT for BCR post-RP.
• Development of a penalized-survival nomogram with internal and external validation.
• Stratification of patients into risk groups based on predicted scores.

Main Results:

• The 5-year DMFS rate was 84%.
• Independent predictors for distant metastasis included pT3/pT4 stage, ISUP grade group 4/5, and SRT within 12 months of surgery.
• The nomogram demonstrated good predictive accuracy with a C-index of 0.70 upon external validation.

Conclusions:

• An externally validated nomogram can accurately predict 5-year DMFS in patients undergoing SRT.
• This tool facilitates personalized risk assessment for high-risk individuals.
• It supports tailored surveillance and treatment strategies for patients post-SRT.