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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MDPI AG
2021-05-01
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| Online Access: | https://www.mdpi.com/2075-1729/11/6/479 |
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| author | Bartosz Małkiewicz Kuba Ptaszkowski Klaudia Knecht Adam Gurwin Karol Wilk Paweł Kiełb Krzysztof Dudek Romuald Zdrojowy |
| author_facet | Bartosz Małkiewicz Kuba Ptaszkowski Klaudia Knecht Adam Gurwin Karol Wilk Paweł Kiełb Krzysztof Dudek Romuald Zdrojowy |
| author_sort | Bartosz Małkiewicz |
| collection | DOAJ |
| 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 <i>p</i> < 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. |
| first_indexed | 2024-03-10T11:04:33Z |
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| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-10T11:04:33Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
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| series | Life |
| spelling | doaj.art-8f959427e0434c4ea6045c2b52bf7cb72023-11-21T21:14:14ZengMDPI AGLife2075-17292021-05-0111647910.3390/life11060479External Validation of the Briganti Nomogram to Predict Lymph Node Invasion in Prostate Cancer—Setting a New Threshold ValueBartosz Małkiewicz0Kuba Ptaszkowski1Klaudia Knecht2Adam Gurwin3Karol Wilk4Paweł Kiełb5Krzysztof Dudek6Romuald Zdrojowy7Department of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, PolandDepartment of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Faculty of Health Science, Wroclaw Medical University, Grunwaldzka 2, 50-355 Wroclaw, PolandDepartment of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, PolandDepartment of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, PolandDepartment of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, PolandDepartment of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, PolandFaculty of Mechanical Engineering, Wroclaw University of Science and Technology, 50-370 Wrocław, PolandDepartment of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland(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 <i>p</i> < 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.https://www.mdpi.com/2075-1729/11/6/479prostate cancerradical prostatectomypelvic lymph node dissectionlymph node invasionpreoperative nomogram |
| spellingShingle | Bartosz Małkiewicz Kuba Ptaszkowski Klaudia Knecht Adam Gurwin Karol Wilk Paweł Kiełb Krzysztof Dudek Romuald Zdrojowy External Validation of the Briganti Nomogram to Predict Lymph Node Invasion in Prostate Cancer—Setting a New Threshold Value Life prostate cancer radical prostatectomy pelvic lymph node dissection lymph node invasion preoperative nomogram |
| 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 | prostate cancer radical prostatectomy pelvic lymph node dissection lymph node invasion preoperative nomogram |
| url | https://www.mdpi.com/2075-1729/11/6/479 |
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