Development and validation of a nomogram for the overall survival of patients with locally advanced prostate cancer treated with radiotherapy and surgery

Prostate cancer (PC) is a common malignancy in older adults. We aimed to construct a nomogram for the overall survival (OS) of elderly patients with locally advanced PC who received radiotherapy and surgery. Clinical and pathological information was downloaded from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015. The selected patients were randomly divided into a training cohort and a validation cohort at a ratio of 7:3. Univariate, multivariate Cox, and stepwise backward regression analyses were used to identify independent risk factors for OS. A total of 2810 elderly patients with locally advanced PC who received radiotherapy and surgery from 2010 to 2015 were included in this study. Age, marital status, Gleason score, tumor stage were identified as independent risk factors for PC patients. Age and marital status primarily reflect background mortality risk. The nomogram demonstrated favorable discrimination and calibration, with AUCs of 0.676–0.774 for 3-, 5-, and 8-year OS, indicating good predictive performance. Decision curve analysis further confirmed its superior clinical net benefit compared with the traditional tumor-node-metastasis staging model. We developed a new nomogram to predict OS in elderly patients with locally advanced PC treated with radiotherapy and surgery.