Predictive Value of Cribriform and Intraductal Carcinoma for the Nomogram-based Selection of Prostate Cancer Patients for Pelvic Lymph Node Dissection.

Autor: de Barros HA; Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands. Electronic address: h.d.barros@nki.nl., Remmers S; Department of Urology, Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands., Luiting HB; Department of Urology, Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands., van Leenders GJLH; Department of Pathology, Erasmus University Medical Centre, Rotterdam, The Netherlands., Roobol MJ; Department of Urology, Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands., Bekers EM; Department of Pathology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Amin A; St Vincent's Prostate Cancer Centre, Darlinghurst, Australia; Garvan Institute of Medical Research, Darlinghurst, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, Australia., Haynes AM; Garvan Institute of Medical Research, Darlinghurst, Australia., Delprado W; Sonic Healthcare and Macquarie University, Sydney, Australia., Stricker PD; St Vincent's Prostate Cancer Centre, Darlinghurst, Australia; Garvan Institute of Medical Research, Darlinghurst, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, Australia., van der Poel HG; Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands; Department of Urology, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands., van der Kwast TH; Laboratory Medicine Program and Princess Margaret Cancer Center, University Health Network, Toronto, Canada., van Leeuwen PJ; Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands.
Jazyk: angličtina
Zdroj: Urology [Urology] 2022 Oct; Vol. 168, pp. 156-164. Date of Electronic Publication: 2022 Jul 05.
DOI: 10.1016/j.urology.2022.04.043
Abstrakt: Objective: To assess the predictive value of biopsy-identified cribriform carcinoma and/or intraductal carcinoma (CR/IDC) within the Briganti and MSKCC nomograms predicting lymph node metastasis (LNM) in patients with primary prostate cancer (PCa).
Methods: We retrospectively included 393 PCa patients who underwent radical prostatectomy with extended pelvic lymph node dissection at 3 tertiary referral centers. We externally validated 2 prediction tools: the Briganti 2012 nomogram and the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram. Both nomograms were augmented with CR/IDC. The original model was compared with the CR/IDC-updated model using the likelihood ratio test. The performance of the prediction tools was assessed using calibration, discrimination, and clinical utility.
Results: Overall, 109 (28%) men were diagnosed with LNM. Calibration plots of the Briganti and MSKCC nomograms demonstrated an underestimation of the LNM risk across clinically relevant thresholds (≤15%). The addition of CR/IDC to the Briganti nomogram increased the fit of the data (χ 2 (1) = 4.30, P = .04), but did not improve the area under the curve (AUC) (0.69, 95% CI 0.63-0.75 vs 0.69, 95% CI 0.64-0.75). Incorporation of CR/IDC in the MSKCC nomogram resulted in an increased fit on the data (χ 2 (1) = 10.04, P <.01), but did not increase the AUC (0.66, 95% CI 0.60-0.72 vs 0.68, 95% CI 0.62-0.74). The addition of CR/IDC to the Briganti and MSKCC nomograms did not improve the clinical risk prediction.
Conclusion: Incorporation of CR/IDC into the 2 clinically most used pre-radical prostatectomy nomograms does not improve LNM prediction in a multinational, contemporary PCa cohort.
Competing Interests: Declarations of Interest None.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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