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External Validation of the Briganti Nomogram to Predict Lymph Node Invasion in Prostate Cancer—Setting a New Threshold Value

(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 t...

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Autores principales: Małkiewicz, Bartosz, Ptaszkowski, Kuba, Knecht, Klaudia, Gurwin, Adam, Wilk, Karol, Kiełb, Paweł, Dudek, Krzysztof, Zdrojowy, Romuald
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227656/
https://www.ncbi.nlm.nih.gov/pubmed/34070313
http://dx.doi.org/10.3390/life11060479
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author Małkiewicz, Bartosz
Ptaszkowski, Kuba
Knecht, Klaudia
Gurwin, Adam
Wilk, Karol
Kiełb, Paweł
Dudek, Krzysztof
Zdrojowy, Romuald
author_facet Małkiewicz, Bartosz
Ptaszkowski, Kuba
Knecht, Klaudia
Gurwin, Adam
Wilk, Karol
Kiełb, Paweł
Dudek, Krzysztof
Zdrojowy, Romuald
author_sort Małkiewicz, Bartosz
collection PubMed
description (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.
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spelling pubmed-82276562021-06-26 External Validation of the Briganti Nomogram to Predict Lymph Node Invasion in Prostate Cancer—Setting a New Threshold Value Małkiewicz, Bartosz Ptaszkowski, Kuba Knecht, Klaudia Gurwin, Adam Wilk, Karol Kiełb, Paweł Dudek, Krzysztof Zdrojowy, Romuald Life (Basel) Article (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. MDPI 2021-05-25 /pmc/articles/PMC8227656/ /pubmed/34070313 http://dx.doi.org/10.3390/life11060479 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Małkiewicz, Bartosz
Ptaszkowski, Kuba
Knecht, Klaudia
Gurwin, Adam
Wilk, Karol
Kiełb, Paweł
Dudek, Krzysztof
Zdrojowy, Romuald
External Validation of the Briganti Nomogram to Predict Lymph Node Invasion in Prostate Cancer—Setting a New Threshold Value
title External Validation of the Briganti Nomogram to Predict Lymph Node Invasion in Prostate Cancer—Setting a New Threshold Value
title_full External Validation of the Briganti Nomogram to Predict Lymph Node Invasion in Prostate Cancer—Setting a New Threshold Value
title_fullStr External Validation of the Briganti Nomogram to Predict Lymph Node Invasion in Prostate Cancer—Setting a New Threshold Value
title_full_unstemmed External Validation of the Briganti Nomogram to Predict Lymph Node Invasion in Prostate Cancer—Setting a New Threshold Value
title_short External Validation of the Briganti Nomogram to Predict Lymph Node Invasion in Prostate Cancer—Setting a New Threshold Value
title_sort external validation of the briganti nomogram to predict lymph node invasion in prostate cancer—setting a new threshold value
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227656/
https://www.ncbi.nlm.nih.gov/pubmed/34070313
http://dx.doi.org/10.3390/life11060479
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