Development and External Validation of a Novel Nomogram to Predict the Probability of Pelvic Lymph-node Metastases in Prostate Cancer Patients Using Magnetic Resonance Imaging and Molecular Imaging with Prostate-specific Membrane Antigen Positron Emission Tomography
Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved..
BACKGROUND: Preoperative assessment of the probability of pelvic lymph-node metastatic disease (pN1) is required to identify patients with prostate cancer (PCa) who are candidates for extended pelvic lymph-node dissection (ePLND).
OBJECTIVE: To develop a novel intuitive prognostic nomogram for predicting pathological lymph-node (pN) status in contemporary patients with primary diagnosed localized PCa, using preoperative clinical and histopathological parameters, magnetic resonance imaging (MRI), and prostate-specific membrane antigen (PSMA) positron emission tomography (PET).
DESIGN, SETTING, AND PARTICIPANTS: In total, 700 eligible patients who underwent robot-assisted radical prostatectomy and ePLND were included in the model-building cohort. The external validation cohort consisted of 305 surgically treated patients. Logistic regression with backward elimination was used to select variables for the Amsterdam-Brisbane-Sydney nomogram.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Performance of the final model was evaluated using the area under the receiver operating characteristic curve (AUC), calibration plots, and decision-curve analyses. Models were subsequently validated in an external population.
RESULTS AND LIMITATIONS: The Amsterdam-Brisbane-Sydney nomogram included initial prostate-specific antigen value, MRI T stage, highest biopsy grade group (GG), biopsy technique, percentage of systematic cores with clinically significant PCa (GG ≥2), and lymph-node status on PSMA-PET. The AUC for predicting pN status was 0.81 (95% confidence interval [CI] 0.78-0.85) for the final model. On external validation, the Amsterdam-Brisbane-Sydney nomogram showed superior discriminative ability to the Briganti-2017 and Memorial Sloan Kettering Cancer Center (MSKCC) nomograms (AUC 0.75 [95% CI 0.69-0.81] vs 0.67 [95% CI 0.61-0.74] and 0.65 [95% CI 0.58-0.72], respectively; p < 0.05), and similar discriminative ability to the Briganti-2019 nomogram (AUC 0.78 [95% CI 0.71-0.86] vs 0.80 [95% CI 0.73-0.86]; p = 0.76). The Amsterdam-Brisbane-Sydney nomogram showed excellent calibration on external validation, with an increased net benefit at a threshold probability of ≥4%.
CONCLUSIONS: The validated Amsterdam-Brisbane-Sydney nomogram performs superior to the Briganti-2017 and MSKCC nomograms, and similar to the Briganti-2019 nomogram. Furthermore, it is applicable in all patients with newly diagnosed unfavorable intermediate- and high-risk PCa.
PATIENT SUMMARY: We developed and validated the Amsterdam-Brisbane-Sydney nomogram for the prediction of prostate cancer spread to lymph nodes before surgery. This nomogram performs similar or superior to all presently available nomograms.
| Errataetall: |
CommentIn: Eur Urol Oncol. 2023 Dec;6(6):564-565. - PMID 37541904 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:6 |
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| Enthalten in: |
European urology oncology - 6(2023), 6 vom: 13. Dez., Seite 553-563 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Vis, André N [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 04.12.2023 Date Revised 11.01.2024 published: Print-Electronic CommentIn: Eur Urol Oncol. 2023 Dec;6(6):564-565. - PMID 37541904 Citation Status MEDLINE |
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| doi: |
10.1016/j.euo.2023.03.010 |
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NLM355500736 |
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| 100 | 1 | |a Vis, André N |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Development and External Validation of a Novel Nomogram to Predict the Probability of Pelvic Lymph-node Metastases in Prostate Cancer Patients Using Magnetic Resonance Imaging and Molecular Imaging with Prostate-specific Membrane Antigen Positron Emission Tomography |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 11.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Eur Urol Oncol. 2023 Dec;6(6):564-565. - PMID 37541904 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND: Preoperative assessment of the probability of pelvic lymph-node metastatic disease (pN1) is required to identify patients with prostate cancer (PCa) who are candidates for extended pelvic lymph-node dissection (ePLND) | ||
| 520 | |a OBJECTIVE: To develop a novel intuitive prognostic nomogram for predicting pathological lymph-node (pN) status in contemporary patients with primary diagnosed localized PCa, using preoperative clinical and histopathological parameters, magnetic resonance imaging (MRI), and prostate-specific membrane antigen (PSMA) positron emission tomography (PET) | ||
| 520 | |a DESIGN, SETTING, AND PARTICIPANTS: In total, 700 eligible patients who underwent robot-assisted radical prostatectomy and ePLND were included in the model-building cohort. The external validation cohort consisted of 305 surgically treated patients. Logistic regression with backward elimination was used to select variables for the Amsterdam-Brisbane-Sydney nomogram | ||
| 520 | |a OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Performance of the final model was evaluated using the area under the receiver operating characteristic curve (AUC), calibration plots, and decision-curve analyses. Models were subsequently validated in an external population | ||
| 520 | |a RESULTS AND LIMITATIONS: The Amsterdam-Brisbane-Sydney nomogram included initial prostate-specific antigen value, MRI T stage, highest biopsy grade group (GG), biopsy technique, percentage of systematic cores with clinically significant PCa (GG ≥2), and lymph-node status on PSMA-PET. The AUC for predicting pN status was 0.81 (95% confidence interval [CI] 0.78-0.85) for the final model. On external validation, the Amsterdam-Brisbane-Sydney nomogram showed superior discriminative ability to the Briganti-2017 and Memorial Sloan Kettering Cancer Center (MSKCC) nomograms (AUC 0.75 [95% CI 0.69-0.81] vs 0.67 [95% CI 0.61-0.74] and 0.65 [95% CI 0.58-0.72], respectively; p < 0.05), and similar discriminative ability to the Briganti-2019 nomogram (AUC 0.78 [95% CI 0.71-0.86] vs 0.80 [95% CI 0.73-0.86]; p = 0.76). The Amsterdam-Brisbane-Sydney nomogram showed excellent calibration on external validation, with an increased net benefit at a threshold probability of ≥4% | ||
| 520 | |a CONCLUSIONS: The validated Amsterdam-Brisbane-Sydney nomogram performs superior to the Briganti-2017 and MSKCC nomograms, and similar to the Briganti-2019 nomogram. Furthermore, it is applicable in all patients with newly diagnosed unfavorable intermediate- and high-risk PCa | ||
| 520 | |a PATIENT SUMMARY: We developed and validated the Amsterdam-Brisbane-Sydney nomogram for the prediction of prostate cancer spread to lymph nodes before surgery. This nomogram performs similar or superior to all presently available nomograms | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Lymph-node metastasis | |
| 650 | 4 | |a Magnetic resonance imaging | |
| 650 | 4 | |a Nomogram | |
| 650 | 4 | |a Pelvic lymph-node dissection | |
| 650 | 4 | |a Prostate cancer | |
| 650 | 4 | |a Prostate-specific membrane antigen positron emission tomography imaging | |
| 700 | 1 | |a Meijer, Dennie |e verfasserin |4 aut | |
| 700 | 1 | |a Roberts, Matthew J |e verfasserin |4 aut | |
| 700 | 1 | |a Siriwardana, Amila R |e verfasserin |4 aut | |
| 700 | 1 | |a Morton, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Yaxley, John W |e verfasserin |4 aut | |
| 700 | 1 | |a Samaratunga, Hemamali |e verfasserin |4 aut | |
| 700 | 1 | |a Emmett, Louise |e verfasserin |4 aut | |
| 700 | 1 | |a van de Ven, Peter M |e verfasserin |4 aut | |
| 700 | 1 | |a Heymans, Martijn W |e verfasserin |4 aut | |
| 700 | 1 | |a Nieuwenhuijzen, Jakko A |e verfasserin |4 aut | |
| 700 | 1 | |a van der Poel, Henk G |e verfasserin |4 aut | |
| 700 | 1 | |a Donswijk, Maarten L |e verfasserin |4 aut | |
| 700 | 1 | |a Boellaard, Thierry N |e verfasserin |4 aut | |
| 700 | 1 | |a Schoots, Ivo G |e verfasserin |4 aut | |
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| 700 | 1 | |a Coughlin, Geoffrey D |e verfasserin |4 aut | |
| 700 | 1 | |a van Leeuwen, Pim J |e verfasserin |4 aut | |
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