Validation of a Nomogram Predicting the Probability of Lymph Node Invasion among Patients Undergoing Radical Prostatectomy and an Extended Pelvic Lymphadenectomy

Alberto Briganti, Felix K H Chun, Andrea Salonia, Giuseppe Zanni, Vincenzo Scattoni, Luc Valiquette, Patrizio Rigatti, Francesco Montorsi, Pierre I. Karakiewicz

Research output: Contribution to journalArticle

174 Citations (Scopus)

Abstract

Introduction: Our goal was to develop and internally validate a nomogram for prediction of lymph node invasion (LNI) in patients with clinically localized prostate cancer undergoing extended pelvic lymphadenectomy (ePLND). Methods: 602 consecutive patients (mean age 65.8 years) underwent an ePLND, where 10 or more nodes were removed. PSA was 1.1-49.9 (median 7.2). Clinical stages were: T1c in 55.6%, T2 in 41.4% and T3 in 3%. Biopsy Gleason sums were: 6 or less in 66%, 7 in 25.4%, 8-10 in 8.6%. Multivariate logistic regression models tested the association between all of the above predictors and LNI. Regression-based coefficients were used to develop a nomogram predicting LNI and 200 bootstrap resamples were used for internal validation. Results: Mean number of lymph nodes removed was 17.1 (range 10-40). LNI was detected in 66 patients (11.0%). Univariate predictive accuracy for total PSA, clinical stage and biopsy Gleason sum was 63%, 58% and 73%, respectively. A nomogram based on clinical stage, PSA and Biopsy Gleason sum demonstrated bootstrap-corrected predictive accuracy of 76%. Conclusions: A nomogram based on pre-treatment PSA, clinical stage and biopsy Gleason sum can highly accurately predict LNI at ePLND.

Original languageEnglish
Pages (from-to)1019-1027
Number of pages9
JournalEuropean Urology
Volume49
Issue number6
DOIs
Publication statusPublished - Jun 2006

Fingerprint

Nomograms
Prostatectomy
Lymph Node Excision
Lymph Nodes
Biopsy
Logistic Models
Prostatic Neoplasms

Keywords

  • Lymph node invasion
  • Nomogram
  • Pelvic lymphadenectomy
  • Prostate cancer

ASJC Scopus subject areas

  • Urology

Cite this

Validation of a Nomogram Predicting the Probability of Lymph Node Invasion among Patients Undergoing Radical Prostatectomy and an Extended Pelvic Lymphadenectomy. / Briganti, Alberto; Chun, Felix K H; Salonia, Andrea; Zanni, Giuseppe; Scattoni, Vincenzo; Valiquette, Luc; Rigatti, Patrizio; Montorsi, Francesco; Karakiewicz, Pierre I.

In: European Urology, Vol. 49, No. 6, 06.2006, p. 1019-1027.

Research output: Contribution to journalArticle

Briganti, Alberto ; Chun, Felix K H ; Salonia, Andrea ; Zanni, Giuseppe ; Scattoni, Vincenzo ; Valiquette, Luc ; Rigatti, Patrizio ; Montorsi, Francesco ; Karakiewicz, Pierre I. / Validation of a Nomogram Predicting the Probability of Lymph Node Invasion among Patients Undergoing Radical Prostatectomy and an Extended Pelvic Lymphadenectomy. In: European Urology. 2006 ; Vol. 49, No. 6. pp. 1019-1027.
@article{9c4f2ffd79da484bb4dc3149087e9dd2,
title = "Validation of a Nomogram Predicting the Probability of Lymph Node Invasion among Patients Undergoing Radical Prostatectomy and an Extended Pelvic Lymphadenectomy",
abstract = "Introduction: Our goal was to develop and internally validate a nomogram for prediction of lymph node invasion (LNI) in patients with clinically localized prostate cancer undergoing extended pelvic lymphadenectomy (ePLND). Methods: 602 consecutive patients (mean age 65.8 years) underwent an ePLND, where 10 or more nodes were removed. PSA was 1.1-49.9 (median 7.2). Clinical stages were: T1c in 55.6{\%}, T2 in 41.4{\%} and T3 in 3{\%}. Biopsy Gleason sums were: 6 or less in 66{\%}, 7 in 25.4{\%}, 8-10 in 8.6{\%}. Multivariate logistic regression models tested the association between all of the above predictors and LNI. Regression-based coefficients were used to develop a nomogram predicting LNI and 200 bootstrap resamples were used for internal validation. Results: Mean number of lymph nodes removed was 17.1 (range 10-40). LNI was detected in 66 patients (11.0{\%}). Univariate predictive accuracy for total PSA, clinical stage and biopsy Gleason sum was 63{\%}, 58{\%} and 73{\%}, respectively. A nomogram based on clinical stage, PSA and Biopsy Gleason sum demonstrated bootstrap-corrected predictive accuracy of 76{\%}. Conclusions: A nomogram based on pre-treatment PSA, clinical stage and biopsy Gleason sum can highly accurately predict LNI at ePLND.",
keywords = "Lymph node invasion, Nomogram, Pelvic lymphadenectomy, Prostate cancer",
author = "Alberto Briganti and Chun, {Felix K H} and Andrea Salonia and Giuseppe Zanni and Vincenzo Scattoni and Luc Valiquette and Patrizio Rigatti and Francesco Montorsi and Karakiewicz, {Pierre I.}",
year = "2006",
month = "6",
doi = "10.1016/j.eururo.2006.01.043",
language = "English",
volume = "49",
pages = "1019--1027",
journal = "European Urology",
issn = "0302-2838",
publisher = "Elsevier B.V.",
number = "6",

}

TY - JOUR

T1 - Validation of a Nomogram Predicting the Probability of Lymph Node Invasion among Patients Undergoing Radical Prostatectomy and an Extended Pelvic Lymphadenectomy

AU - Briganti, Alberto

AU - Chun, Felix K H

AU - Salonia, Andrea

AU - Zanni, Giuseppe

AU - Scattoni, Vincenzo

AU - Valiquette, Luc

AU - Rigatti, Patrizio

AU - Montorsi, Francesco

AU - Karakiewicz, Pierre I.

PY - 2006/6

Y1 - 2006/6

N2 - Introduction: Our goal was to develop and internally validate a nomogram for prediction of lymph node invasion (LNI) in patients with clinically localized prostate cancer undergoing extended pelvic lymphadenectomy (ePLND). Methods: 602 consecutive patients (mean age 65.8 years) underwent an ePLND, where 10 or more nodes were removed. PSA was 1.1-49.9 (median 7.2). Clinical stages were: T1c in 55.6%, T2 in 41.4% and T3 in 3%. Biopsy Gleason sums were: 6 or less in 66%, 7 in 25.4%, 8-10 in 8.6%. Multivariate logistic regression models tested the association between all of the above predictors and LNI. Regression-based coefficients were used to develop a nomogram predicting LNI and 200 bootstrap resamples were used for internal validation. Results: Mean number of lymph nodes removed was 17.1 (range 10-40). LNI was detected in 66 patients (11.0%). Univariate predictive accuracy for total PSA, clinical stage and biopsy Gleason sum was 63%, 58% and 73%, respectively. A nomogram based on clinical stage, PSA and Biopsy Gleason sum demonstrated bootstrap-corrected predictive accuracy of 76%. Conclusions: A nomogram based on pre-treatment PSA, clinical stage and biopsy Gleason sum can highly accurately predict LNI at ePLND.

AB - Introduction: Our goal was to develop and internally validate a nomogram for prediction of lymph node invasion (LNI) in patients with clinically localized prostate cancer undergoing extended pelvic lymphadenectomy (ePLND). Methods: 602 consecutive patients (mean age 65.8 years) underwent an ePLND, where 10 or more nodes were removed. PSA was 1.1-49.9 (median 7.2). Clinical stages were: T1c in 55.6%, T2 in 41.4% and T3 in 3%. Biopsy Gleason sums were: 6 or less in 66%, 7 in 25.4%, 8-10 in 8.6%. Multivariate logistic regression models tested the association between all of the above predictors and LNI. Regression-based coefficients were used to develop a nomogram predicting LNI and 200 bootstrap resamples were used for internal validation. Results: Mean number of lymph nodes removed was 17.1 (range 10-40). LNI was detected in 66 patients (11.0%). Univariate predictive accuracy for total PSA, clinical stage and biopsy Gleason sum was 63%, 58% and 73%, respectively. A nomogram based on clinical stage, PSA and Biopsy Gleason sum demonstrated bootstrap-corrected predictive accuracy of 76%. Conclusions: A nomogram based on pre-treatment PSA, clinical stage and biopsy Gleason sum can highly accurately predict LNI at ePLND.

KW - Lymph node invasion

KW - Nomogram

KW - Pelvic lymphadenectomy

KW - Prostate cancer

UR - http://www.scopus.com/inward/record.url?scp=33646361322&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33646361322&partnerID=8YFLogxK

U2 - 10.1016/j.eururo.2006.01.043

DO - 10.1016/j.eururo.2006.01.043

M3 - Article

C2 - 16530933

AN - SCOPUS:33646361322

VL - 49

SP - 1019

EP - 1027

JO - European Urology

JF - European Urology

SN - 0302-2838

IS - 6

ER -