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Sloan Kettering Nomogram change

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Posted 5/20/2015 7:12 PM (GMT 0)
Has anyone else noticed a DRASTIC change in their predicted BCR free survival rates with recent updates to MSKCC Nomograms? My 10 year BCR free survival rate went from 94% before the updates to 69% now. What's changed? Is the new method they are apparently using more accurate? If so, sheez! The old way must have been pretty bad. I think before the updates, you were able to provide your current PSA level. Now it simply asks how many months you've been cancer free. I know that these nomograms have limited accuracy, but a 25% change?!! That changes the picture pretty drastically. Has anyone else noticed this? I haven't seen much discussion. Perhaps, I'm the only one that obsesses over these predictive tools.
Posted 5/20/2015 8:37 PM (GMT 0)
Thanks for mentioning the update (I think). I entered my numbers and it says I have 0% chance of being BCR free 6 years after SRT. And, I guess they are right. My PSA is almost to 0.1. This only confirms what I have believed for some time - I screwed up big time when I chose surgery over combo Brachy and IMRT.
Posted 5/21/2015 1:35 AM (GMT 0)
I would think they would go the other way as the experience of Xtandi, Zytiga, Xofigo, Provenge, better chemo get factored in.
Posted 5/21/2015 2:50 AM (GMT 0)

Jim, you said...
I would think they would go the other way as the experience of Xtandi, Zytiga, Xofigo, Provenge, better chemo get factored in.

Umm... Aren't those all treatments that are used mostly after BCR?

Xofigo is radioactive but I don't think any of them are retroactive.
Posted 5/21/2015 3:07 AM (GMT 0)
I looked at the nomogram tonight after seeing this thread. My numbers didn't really change, maybe a 1% difference
Posted 5/21/2015 3:49 AM (GMT 0)
I just re-checked my numbers on the nomogram.
Prior results were 99% BCR free at 7 years
Current nomogram predicts 97% BCR free at 7 years.
So a minor update to nomogram it appears.
61 months since surgery and continue to be "undetectable".
Fingers crossed for all of us on this journey.
Posted 5/21/2015 10:20 AM (GMT 0)
Can't seem to find a nomogram that fits my profile - RP + Adj RT + Adj HT.

Even if there was one it would need to take into account the length of HT.

Guess I'll just have to live in suspense!

Chas
Posted 5/21/2015 11:05 PM (GMT 0)
Mine are exactly the same as six months ago - I wrote down the numbers just in case...99%, 98% ,97% & 95% at 2, 5, 7 & 10 years.
Posted 5/21/2015 11:58 PM (GMT 0)
To the OP question, it sounds to me as if MSK has updated their nomogram based on better data. The best way to project the effectiveness of a treatment 10 years out is to look at data that goes back that far...or farther. I would tend to question projections of effectiveness that go out further than the treatment in question has been in wide use. For example, it would be questionable to project the long term effectiveness of Proton treatment simply because it's not in wide use and there aren't a lot of patients to look at.
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