PURPOSE Prognostic models are developed to estimate the probability of the occurrence of future outcomes incorporating multiple variables. We aimed to identify and summarize existing multivariable prognostic models developed for predicting overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC). METHODS The protocol was prospectively registered (CRD42017064448). We systematically searched Medline and reference lists up to May 2018 and included experimental and observational studies, which developed and/or internally validated prognostic models for mCRPC patients and were further externally validated or updated. The outcome of interest was overall survival. Two authors independently performed literature screening and quality assessment. RESULTS We included 12 studies that developed models including 8750 patients aged 42-95 years. Models included 4-11 predictor variables, mostly hemoglobin, baseline PSA, alkaline phosphatase, performance status, and lactate dehydrogenase. Very few incorporated Gleason score. Two models included predictors related to docetaxel and mitoxantrone treatments. Model performance after internal validation showed similar discrimination power ranging from 0.62 to 0.73. Overall survival models were mainly constructed as nomograms or risk groups/score. Two models obtained an overall judgment of low risk of bias. CONCLUSIONS Most models were not suitable for clinical use due to methodological shortcomings and lack of external validation. Further external validation and/or model updating is required to increase prognostic accuracy and clinical applicability prior to their incorporation in clinical practice as a useful tool in patient management.

中文翻译：

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预测转移性去势抵抗性前列腺癌总生存期的预后模型：系统评价。

目的 开发预后模型以估计包含多个变量的未来结果发生的概率。我们旨在确定和总结现有的多变量预后模型，用于预测转移性去势抵抗性前列腺癌 (mCRPC) 患者的总生存期。方法 该方案是前瞻性注册的（CRD42017064448）。我们系统地检索了截至 2018 年 5 月的 Medline 和参考文献列表，包括实验性和观察性研究，这些研究为 mCRPC 患者开发和/或内部验证了预后模型，并进一步进行了外部验证或更新。感兴趣的结果是总生存期。两位作者独立进行了文献筛选和质量评估。结果 我们纳入了 12 项研究，这些研究开发了包括 8750 名 42-95 岁患者在内的模型。模型包括 4-11 个预测变量，主要是血红蛋白、基线 PSA、碱性磷酸酶、体能状态和乳酸脱氢酶。很少有纳入格里森分数。两个模型包括与多西他赛和米托蒽醌治疗相关的预测因子。内部验证后的模型性能显示出类似的区分能力，范围从 0.62 到 0.73。总体生存模型主要构建为列线图或风险组/分数。两个模型获得了低偏倚风险的总体判断。结论 由于方法学缺陷和缺乏外部验证，大多数模型不适合临床使用。