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A preoperative nomogram identifying decreased risk of positive pelvic lymph nodes in patients with prostate cancer.
J Urol. 2003 Nov; 170(5):1798-803.JU

Abstract

PURPOSE

We developed a preoperative nomogram for prediction of lymph node metastases in patients with clinically localized prostate cancer.

MATERIALS AND METHODS

The study was a retrospective, nonrandomized analysis of 7,014 patients treated with radical prostatectomy at 6 institutions between 1985 and 2000. Exclusion criteria consisted of preoperative androgen ablation therapy, salvage radical prostatectomy and pretreatment prostate specific antigen (PSA) greater than 50 ng/ml. Preoperative predictors of lymph node metastases consisted of pretreatment PSA, clinical stage (1992 TNM) and biopsy Gleason sum. These predictors were used in logistic regression analysis based nomograms to predict the probability of lymph node metastases.

RESULTS

Overall 5,510 patients with complete clinical and pathological information were included in the study. Lymph nodes metastases were present in 206 patients (3.7%). Pretreatment PSA, biopsy Gleason sum, clinical stage and institution represented predictors of lymph node status (p <0.001). Bootstrap corrected predictive accuracy of the 3-variable nomogram (clinical stage, Gleason sum and PSA) was 0.76. Inclusion of a fourth variable, which accounts for institutional differences in lymph node metastases, yielded an area under the receiver operating characteristics curve of 0.78. The negative predictive value of our nomograms was 0.99 when they predicted 3% or less chance of positive lymph nodes.

CONCLUSIONS

Using clinical information, we produced 2 calibrated and validated nomograms, which accurately predict pathologically negative lymph nodes in men with localized prostate cancer who are candidates for radical prostatectomy.

Authors+Show Affiliations

Department of Urology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14532779

Citation

Cagiannos, Ilias, et al. "A Preoperative Nomogram Identifying Decreased Risk of Positive Pelvic Lymph Nodes in Patients With Prostate Cancer." The Journal of Urology, vol. 170, no. 5, 2003, pp. 1798-803.
Cagiannos I, Karakiewicz P, Eastham JA, et al. A preoperative nomogram identifying decreased risk of positive pelvic lymph nodes in patients with prostate cancer. J Urol. 2003;170(5):1798-803.
Cagiannos, I., Karakiewicz, P., Eastham, J. A., Ohori, M., Rabbani, F., Gerigk, C., Reuter, V., Graefen, M., Hammerer, P. G., Erbersdobler, A., Huland, H., Kupelian, P., Klein, E., Quinn, D. I., Henshall, S. M., Grygiel, J. J., Sutherland, R. L., Stricker, P. D., Morash, C. G., ... Kattan, M. W. (2003). A preoperative nomogram identifying decreased risk of positive pelvic lymph nodes in patients with prostate cancer. The Journal of Urology, 170(5), 1798-803.
Cagiannos I, et al. A Preoperative Nomogram Identifying Decreased Risk of Positive Pelvic Lymph Nodes in Patients With Prostate Cancer. J Urol. 2003;170(5):1798-803. PubMed PMID: 14532779.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A preoperative nomogram identifying decreased risk of positive pelvic lymph nodes in patients with prostate cancer. AU - Cagiannos,Ilias, AU - Karakiewicz,Pierre, AU - Eastham,James A, AU - Ohori,Makato, AU - Rabbani,Farhang, AU - Gerigk,Claudia, AU - Reuter,Victor, AU - Graefen,Markus, AU - Hammerer,Peter G, AU - Erbersdobler,Andreas, AU - Huland,Hartwig, AU - Kupelian,Patrick, AU - Klein,Eric, AU - Quinn,David I, AU - Henshall,Susan M, AU - Grygiel,John J, AU - Sutherland,Robert L, AU - Stricker,Phillip D, AU - Morash,Christopher G, AU - Scardino,Peter T, AU - Kattan,Michael W, PY - 2003/10/9/pubmed PY - 2003/12/3/medline PY - 2003/10/9/entrez SP - 1798 EP - 803 JF - The Journal of urology JO - J Urol VL - 170 IS - 5 N2 - PURPOSE: We developed a preoperative nomogram for prediction of lymph node metastases in patients with clinically localized prostate cancer. MATERIALS AND METHODS: The study was a retrospective, nonrandomized analysis of 7,014 patients treated with radical prostatectomy at 6 institutions between 1985 and 2000. Exclusion criteria consisted of preoperative androgen ablation therapy, salvage radical prostatectomy and pretreatment prostate specific antigen (PSA) greater than 50 ng/ml. Preoperative predictors of lymph node metastases consisted of pretreatment PSA, clinical stage (1992 TNM) and biopsy Gleason sum. These predictors were used in logistic regression analysis based nomograms to predict the probability of lymph node metastases. RESULTS: Overall 5,510 patients with complete clinical and pathological information were included in the study. Lymph nodes metastases were present in 206 patients (3.7%). Pretreatment PSA, biopsy Gleason sum, clinical stage and institution represented predictors of lymph node status (p <0.001). Bootstrap corrected predictive accuracy of the 3-variable nomogram (clinical stage, Gleason sum and PSA) was 0.76. Inclusion of a fourth variable, which accounts for institutional differences in lymph node metastases, yielded an area under the receiver operating characteristics curve of 0.78. The negative predictive value of our nomograms was 0.99 when they predicted 3% or less chance of positive lymph nodes. CONCLUSIONS: Using clinical information, we produced 2 calibrated and validated nomograms, which accurately predict pathologically negative lymph nodes in men with localized prostate cancer who are candidates for radical prostatectomy. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/14532779/A_preoperative_nomogram_identifying_decreased_risk_of_positive_pelvic_lymph_nodes_in_patients_with_prostate_cancer_ L2 - https://www.jurology.com/doi/10.1097/01.ju.0000091805.98960.13?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -