On the probability of lymph node negativity in pN0-staged prostate cancer—a theoretically derived rule of thumb for adjuvant needs.

Autor: Paulsen, Frank, Bedke, Jens, Wegener, Daniel, Marzec, Jolanta, Martus, Peter, Nann, Dominik, Stenzl, Arnulf, Zips, Daniel, Müller, Arndt-Christian
Zdroj: Strahlentherapie und Onkologie; Aug2022, Vol. 198 Issue 8, p690-699, 10p
Abstrakt: Purpose: The extent of lymphadenectomy and clinical features influence the risk of occult nodes in node-negative prostate cancer. We derived a simple estimation model for the negative predictive value (npv) of histopathologically node-negative prostate cancer patients (pN0) to guide adjuvant treatment. Methods: Approximations of sensitivities in detecting lymph node metastasis from current publications depending on the number of removed lymph nodes were used for a theoretical deduction of a simplified formulation of npv assuming a false node positivity of 0. Results: A theoretical formula of npv = p(N0IpN0) = (100 − prevalence) / (100 − sensitivity × prevalence) was calculated (sensitivity and preoperative prevalence in %). Depending on the number of removed lymph nodes (nLN), the sensitivity of pN0-staged prostate cancer was derived for three sensitivity levels accordingly: sensitivity = f(nLN) = 9 × nLN /100 for 0 ≤ nLN ≤ 8 and f(nLN) = (nLN + 70) /100 for 9 ≤ nLN ≤ 29 and f(nLN) = 1 for nLN ≥ 30. Conclusion: We developed a theoretical formula for estimation of the npv in pN0-staged prostate cancer patients. It is a sine qua non to use the formula in a clinically experienced context before deciding to electively irradiate pelvic lymph nodes or to intensify adjuvant systemic treatment. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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