Development and internal validation of a novel nomogram for predicting lymph node invasion for prostate cancer patients undergoing extended pelvic lymph node dissection
BackgroundFew studies have focused on the performance of Briganti 2012, Briganti 2017 and MSKCC nomograms in the Chinese population in assessing the risk of lymph node invasion(LNI) in prostate cancer(PCa) patients and identifying patients suitable for extended pelvic lymph node dissection(ePLND). W...
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| Format: | Article |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1186319/full |
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| author | Zhen Li Zhen Li Yixin Huang Yixin Huang Diwei Zhao Diwei Zhao Xin Luo Xin Luo Zeshen Wu Xinyi Zheng Ye Xie Yixuan Liu Jianwei Wu Yulu Peng Yulu Peng Yonghong Li Yonghong Li Fangjian Zhou Fangjian Zhou |
| author_facet | Zhen Li Zhen Li Yixin Huang Yixin Huang Diwei Zhao Diwei Zhao Xin Luo Xin Luo Zeshen Wu Xinyi Zheng Ye Xie Yixuan Liu Jianwei Wu Yulu Peng Yulu Peng Yonghong Li Yonghong Li Fangjian Zhou Fangjian Zhou |
| author_sort | Zhen Li |
| collection | DOAJ |
| description | BackgroundFew studies have focused on the performance of Briganti 2012, Briganti 2017 and MSKCC nomograms in the Chinese population in assessing the risk of lymph node invasion(LNI) in prostate cancer(PCa) patients and identifying patients suitable for extended pelvic lymph node dissection(ePLND). We aimed to develop and validate a novel nomogram based on Chinese PCa patients treated with radical prostatectomy(RP) and ePLND for predicting LNI.MethodsWe retrospectively retrieved clinical data of 631 patients with localized PCa receiving RP and ePLND at a Chinese single tertiary referral center. All patients had detailed biopsy information from experienced uropathologist. Multivariate logistic-regression analyses were performed to identify independent factors associated with LNI. The discrimination accuracy and net-benefit of models were quantified using the area under curve(AUC) and Decision curve analysis(DCA).The nonparametric bootstrapping were used to internal validation.ResultsA total of 194(30.7%) patients had LNI. The median number of removed lymph nodes was 13(range, 11-18). In univariable analysis, preoperative prostate-specific antigen(PSA), clinical stage, biopsy Gleason grade group, maximum percentage of single core involvement with highest-grade PCa, percentage of positive cores, percentage of positive cores with highest-grade PCa and percentage of cores with clinically significant cancer on systematic biopsy differed significantly. The multivariable model that included preoperative PSA, clinical stage, biopsy Gleason grade group, maximum percentage of single core involvement with highest-grade PCa and percentage of cores with clinically significant cancer on systematic biopsy represented the basis for the novel nomogram. Based on a 12% cutoff, our results showed that 189(30%) patients could have avoided ePLND while only 9(4.8%) had LNI missing ePLND. Our proposed model achieved the highest AUC (proposed model vs Briganti 2012 vs Briganti 2017 vs MSKCC model: 0.83 vs 0.8 vs 0.8 vs 0.8, respectively) and highest net-benefit via DCA in the Chinese cohort compared with previous nomograms. In internal validation of proposed nomogram, all variables had a percent inclusion greater than 50%.ConclusionWe developed and validated a nomogram predicting the risk of LNI based on Chinese PCa patients, which demonstrated superior performance compared with previous nomograms. |
| first_indexed | 2024-04-09T13:56:40Z |
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| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-09T13:56:40Z |
| publishDate | 2023-05-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-48fc4667867e44b992a5d52e2d8b7de22023-05-08T04:29:38ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-05-011310.3389/fonc.2023.11863191186319Development and internal validation of a novel nomogram for predicting lymph node invasion for prostate cancer patients undergoing extended pelvic lymph node dissectionZhen Li0Zhen Li1Yixin Huang2Yixin Huang3Diwei Zhao4Diwei Zhao5Xin Luo6Xin Luo7Zeshen Wu8Xinyi Zheng9Ye Xie10Yixuan Liu11Jianwei Wu12Yulu Peng13Yulu Peng14Yonghong Li15Yonghong Li16Fangjian Zhou17Fangjian Zhou18Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Urology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Urology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Urology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Urology, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), Shenzhen, ChinaZhongshan School of Medicine, Sun Yat-sen University, Guangzhou, ChinaZhongshan School of Medicine, Sun Yat-sen University, Guangzhou, ChinaZhongshan School of Medicine, Sun Yat-sen University, Guangzhou, ChinaSchool of Clinical Medicine, Tianjin Medical University, Tianjin, ChinaDepartment of Urology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Urology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Urology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaBackgroundFew studies have focused on the performance of Briganti 2012, Briganti 2017 and MSKCC nomograms in the Chinese population in assessing the risk of lymph node invasion(LNI) in prostate cancer(PCa) patients and identifying patients suitable for extended pelvic lymph node dissection(ePLND). We aimed to develop and validate a novel nomogram based on Chinese PCa patients treated with radical prostatectomy(RP) and ePLND for predicting LNI.MethodsWe retrospectively retrieved clinical data of 631 patients with localized PCa receiving RP and ePLND at a Chinese single tertiary referral center. All patients had detailed biopsy information from experienced uropathologist. Multivariate logistic-regression analyses were performed to identify independent factors associated with LNI. The discrimination accuracy and net-benefit of models were quantified using the area under curve(AUC) and Decision curve analysis(DCA).The nonparametric bootstrapping were used to internal validation.ResultsA total of 194(30.7%) patients had LNI. The median number of removed lymph nodes was 13(range, 11-18). In univariable analysis, preoperative prostate-specific antigen(PSA), clinical stage, biopsy Gleason grade group, maximum percentage of single core involvement with highest-grade PCa, percentage of positive cores, percentage of positive cores with highest-grade PCa and percentage of cores with clinically significant cancer on systematic biopsy differed significantly. The multivariable model that included preoperative PSA, clinical stage, biopsy Gleason grade group, maximum percentage of single core involvement with highest-grade PCa and percentage of cores with clinically significant cancer on systematic biopsy represented the basis for the novel nomogram. Based on a 12% cutoff, our results showed that 189(30%) patients could have avoided ePLND while only 9(4.8%) had LNI missing ePLND. Our proposed model achieved the highest AUC (proposed model vs Briganti 2012 vs Briganti 2017 vs MSKCC model: 0.83 vs 0.8 vs 0.8 vs 0.8, respectively) and highest net-benefit via DCA in the Chinese cohort compared with previous nomograms. In internal validation of proposed nomogram, all variables had a percent inclusion greater than 50%.ConclusionWe developed and validated a nomogram predicting the risk of LNI based on Chinese PCa patients, which demonstrated superior performance compared with previous nomograms.https://www.frontiersin.org/articles/10.3389/fonc.2023.1186319/fullChinese populationlymph node invasionnomogramprostate cancerpelvic lymph node dissection |
| spellingShingle | Zhen Li Zhen Li Yixin Huang Yixin Huang Diwei Zhao Diwei Zhao Xin Luo Xin Luo Zeshen Wu Xinyi Zheng Ye Xie Yixuan Liu Jianwei Wu Yulu Peng Yulu Peng Yonghong Li Yonghong Li Fangjian Zhou Fangjian Zhou Development and internal validation of a novel nomogram for predicting lymph node invasion for prostate cancer patients undergoing extended pelvic lymph node dissection Frontiers in Oncology Chinese population lymph node invasion nomogram prostate cancer pelvic lymph node dissection |
| title | Development and internal validation of a novel nomogram for predicting lymph node invasion for prostate cancer patients undergoing extended pelvic lymph node dissection |
| title_full | Development and internal validation of a novel nomogram for predicting lymph node invasion for prostate cancer patients undergoing extended pelvic lymph node dissection |
| title_fullStr | Development and internal validation of a novel nomogram for predicting lymph node invasion for prostate cancer patients undergoing extended pelvic lymph node dissection |
| title_full_unstemmed | Development and internal validation of a novel nomogram for predicting lymph node invasion for prostate cancer patients undergoing extended pelvic lymph node dissection |
| title_short | Development and internal validation of a novel nomogram for predicting lymph node invasion for prostate cancer patients undergoing extended pelvic lymph node dissection |
| title_sort | development and internal validation of a novel nomogram for predicting lymph node invasion for prostate cancer patients undergoing extended pelvic lymph node dissection |
| topic | Chinese population lymph node invasion nomogram prostate cancer pelvic lymph node dissection |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1186319/full |
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