External Validation of the Briganti Nomogram to Predict Lymph Node Invasion in Prostate Cancer—Setting a New Threshold Value
| Autor: | Paweł Kiełb, Bartosz Małkiewicz, Adam Gurwin, Kuba Ptaszkowski, Klaudia Knecht, Romuald Zdrojowy, Krzysztof Dudek, Karol Wilk |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Science 030232 urology & nephrology Urology lymph node invasion urologic and male genital diseases Article General Biochemistry Genetics and Molecular Biology 03 medical and health sciences Prostate cancer 0302 clinical medicine Biopsy medicine Stage (cooking) Lymph node Ecology Evolution Behavior and Systematics Receiver operating characteristic medicine.diagnostic_test Prostatectomy business.industry Paleontology Nomogram medicine.disease prostate cancer radical prostatectomy pelvic lymph node dissection medicine.anatomical_structure Space and Planetary Science 030220 oncology & carcinogenesis preoperative nomogram Lymph business |
| Zdroj: | Life, Vol 11, Iss 479, p 479 (2021) Life Volume 11 Issue 6 |
| ISSN: | 2075-1729 |
| Popis: | (1) Introduction: The study aimed to test and validate the performance of the 2012 Briganti nomogram as a predictor for pelvic lymph node invasion (LNI) in men who underwent radical prostatectomy (RP) with extended pelvic lymph node dissection (PLND) to examine their performance and to analyse the therapeutic impact of using a different nomogram cut-off. (2) Material and Methods: The study group consisted of 222 men with clinically localized prostate cancer (PCa) who underwent RP with ePLND between 01/2012 and 10/2018. Measurements included: preoperative PSA, clinical stage (CS), primary and secondary biopsy Gleason pattern, and the percentage of positive cores. The area under the curve (AUC) of the receiver operator characteristic analysis was appointed to quantify the accuracy of the primary nomogram model to predict LNI. The extent of estimation associated with the use of this model was graphically depicted using calibration plots. (3) Results: The median number of removed lymph nodes was 16 (IQR 12–21). A total of 53 of 222 patients (23.9%) had LNI. Preoperative clinical and biopsy characteristics differed significantly (all p < 0.005) between men with and without LNI. A nomogram-derived cut-off of 7% could lead to a reduction of 43% (95/222) of lymph node dissection while omitting 19% (10/53) of patients with LNI. The sensitivity, specificity, and negative predictive value associated with the 7% cut-off were 81.1%, 50.3%, and 96.3%, respectively. (4) Conclusions: The analysed nomogram demonstrated high accuracy for LNI prediction. A nomogram-derived cut-off of 7% confirmed good performance characteristics within the first external validation cohort from Poland. |
| Databáze: | OpenAIRE |
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