External validation of nomogram predicting the probability of specimen-confined disease (pT2-3a, R0N0) in patients undergoing radical prostatectomy and pelvic lymph node dissection

Luigi Mearini, Mauro Gacci, Omar Saleh, Cosimo De Nunzio, Riccardo Schiavina, Alchiede Simonato, Andrea Tubaro, Giorgio Carmignani, Vincenzo Mirone, Marco Carini, Vittorio Bini, Massimo Porena

Research output: Contribution to journalArticle

Abstract

Introduction: Before radical prostatectomy (RP), a nomogram [Briganti et al., Eur Urol 2012; 61: 584-592] permits to measure the probability of specimen-confined (SC) disease (pT2-pT3a, node negative with negative margins) in highrisk prostate cancer (PCa). The aim of our study was to perform an external validation of this nomogram.

Materials and Methods: Between 2007 and 2011, 623 patients with highrisk PCa (prostate-specific antigen (PSA) >20 ng/ml and/or biopsy Gleason score = 8 and/or clinical stage T3) underwent RP and pelvic lymph node dissection at tertiary referral cen- ters. Multivariable logistic regression models predicting the presence of SC disease were built in; we then used the area under curve of the receiver operating characteristic analysis to quantify accuracy of the nomogram to predict SC disease. The extent of over- or underestimation was evaluated within calibration plots.

Results: 29% (181/623) of men had SC disease at RP. Preoperative PSA, biopsy Gleason score and stage differed significantly (all p <0.001) between men with SC disease and those without. External validation of the nomogram showed an acceptable accuracy (area under curve: 66.3, 95% CI 62.4-70%) and a perfect calibration plot.

Conclusions: The external cohort validates the original nomogram, with perfect calibration characteristics. The adequate although reduced accuracy may reflect the wide spectrum and behavior of the so-called high-risk PCa.

Original languageEnglish
Pages (from-to)262-268
Number of pages7
JournalUrologia Internationalis
Volume93
Issue number3
DOIs
Publication statusPublished - Nov 7 2014

Keywords

  • High-risk prostate cancer
  • Nomogram
  • Radical prostatectomy

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

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    Mearini, L., Gacci, M., Saleh, O., De Nunzio, C., Schiavina, R., Simonato, A., Tubaro, A., Carmignani, G., Mirone, V., Carini, M., Bini, V., & Porena, M. (2014). External validation of nomogram predicting the probability of specimen-confined disease (pT2-3a, R0N0) in patients undergoing radical prostatectomy and pelvic lymph node dissection. Urologia Internationalis, 93(3), 262-268. https://doi.org/10.1159/000354430