External validation of the Briganti nomogram predicting lymph node invasion in patients with intermediate and high-risk prostate cancer diagnosed with magnetic resonance imaging-targeted and systematic biopsies: A European multicenter study
| Autor: | Simone Albisinni, Maxime Rossi, Alexandre Fourcade, Marco Oderda, Grégoire Assenmacher, Gaelle Fiard, Ilyas Svistakov, Daniel Benamran, Jean Louis Bonnal, Romain Diamand, Georges Fournier, Giuseppe Simone, Jean Baptiste Roche, Christophe Iselin, Giacomo Di Cosmo, Thierry Roumeguere, Paolo Gontero, Eric Mandron, J.L. Descotes, Alexandre Peltier, Julien Van Damme |
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| Rok vydání: | 2020 |
| Předmět: |
Image-Guided Biopsy
Male medicine.medical_specialty Urology medicine.medical_treatment 030232 urology & nephrology Risk Assessment Nomogram 03 medical and health sciences Prostate cancer 0302 clinical medicine Humans Medicine Neoplasm Invasiveness Lymph node Aged Retrospective Studies medicine.diagnostic_test Receiver operating characteristic business.industry Prostatectomy Prostatic Neoplasms Magnetic resonance imaging Middle Aged Prognosis medicine.disease Magnetic Resonance Imaging Europe Nomograms Dissection Settore MED/24 medicine.anatomical_structure Oncology Targeted biopsy Lymphatic Metastasis 030220 oncology & carcinogenesis Cohort Lymph node invasion MRI Radiology business |
| Zdroj: | Urologic Oncology: Seminars and Original Investigations. 38:847.e9-847.e16 |
| ISSN: | 1078-1439 |
| DOI: | 10.1016/j.urolonc.2020.04.011 |
| Popis: | To validate a nomogram predicting lymph node invasion (LNI) in prostate cancer patients undergoing radical prostatectomy taking into consideration multiparametric-magnetic resonance imaging (mp-MRI) parameters and targeted biopsies in a western European cohort.A total of 473 men diagnosed by targeted biopsies, using software-based MRI-ultrasound image fusion system, and operated by radical prostatectomy with extended pelvic lymph node dissection across 11 Europeans centers between 2012 and 2019 were identified. Area under the curve of the receiver operator characteristic curve, calibration plot and decision curve analysis were used to evaluated the performance of the model.Overall, 56 (11.8%) patients had LNI on final pathologic examination with a median (IQR) of 13 (9-18) resected nodes. Significant differences (all P0.05) were found between patients with and without LNI in terms of preoperative PSA, clinical stage at DRE and mp-MRI, maximum diameter of the index lesion, PI-RADS score, Grade Group on systematic and targeted biopsies, total number of dissected lymph nodes, final pathologic staging and Grade Group. External validation of the prediction model showed a good accuracy with an area under the curve calculated as 0.8 (CI 95% 0.75-0.86). Graphic analysis of calibration plot and decision curve analysis showed a slight underestimation for predictive probability for LNI between 3% and 22% and a high net benefit. A cut-off at 7% was associated with a risk of missing LNI in 2.6%, avoiding unnecessary surgeries in 55.9%.We report an external validation of the nomogram predicting LNI in patients treated with extended pelvic lymph node dissection in a western European cohort and a cut-off at 7% seems appropriate. |
| Databáze: | OpenAIRE |
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