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External Validation of Nomograms for Predicting Pelvic Lymph Node Metastases in Patients with Prostate Cancer and the Added Value of the Prostate-specific Membrane Antigen Positron Emission Tomography–based PRIMARY Score

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Názov: External Validation of Nomograms for Predicting Pelvic Lymph Node Metastases in Patients with Prostate Cancer and the Added Value of the Prostate-specific Membrane Antigen Positron Emission Tomography–based PRIMARY Score
Autori: Muhammet Demirbilek, Göktuğ Kalender, Said Bıyıkoglu, Sertaç Asa, Emre Akkuş, İclal Gürses, Levent Kabasakal, Bülent Önal
Zdroj: European Urology Open Science, Vol 82, Iss , Pp 170-177 (2025)
Informácie o vydavateľovi: Elsevier, 2025.
Rok vydania: 2025
Zbierka: LCC:Diseases of the genitourinary system. Urology
LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Predmety: Amsterdam-Brisbane-Sydney nomogram, Pelvic lymph node dissection, PRIMARY score, Prostate cancer, Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Popis: Background and objective: The aim of our study was to predict pathological lymph node involvement (stage pN1) in patients undergoing radical prostatectomy (RP) and extended pelvic lymph node dissection (ePLND) for prostate cancer (PC) and to compare the performance of nomograms used in ePLND decision-making. Methods: Data for 191 patients with PC who underwent and ePLND between 2018 and 2023 were analyzed retrospectively. Demographics, prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) results, and multiparametric magnetic resonance imaging (mpMRI) findings were assessed in relation to pN1 prediction and nomogram comparison. Statistical analyses included χ2 and Mann-Whitney U tests. New models in which PSMA PET/CT parameters (PRIMARY score, mean and maximum intraprostatic standardized uptake values) were incorporated in the Amsterdam-Brisbane-Sydney nomogram were evaluated using the area under the receiver operating characteristic curve (AUC) in a second analysis for a subset of 139 patients. The performance of the new models was analyzed using likelihood ratio tests. Key findings and limitations: In the primary cohort of 191 patients, 35 (18.3%) had stage pN1 at RP. AUC values were 0.751 (95% confidence interval [CI] 0.676–0.826) for the Briganti 2012 nomogram, 0.722 (95% CI 0.641–0.803) for the Briganti 2017 nomogram, 0.725 (95% CI 0.643–0.807) for the Memorial Sloan Kettering Cancer Center nomogram, and 0.862 (95% CI 0.794–0.929) for the Amsterdam-Brisbane-Sydney nomogram. In the second analysis for the subset of 139 patients, the PRIMARY score was significantly higher in the pN1 group (p = 0.011). The AUC for a new model incorporating the PRIMARY score in the Amsterdam-Brisbane-Sydney nomogram was 0.870 (95% CI 0.791–0.949), which surpasses AUC results for the other models. The performance of the newly developed models was significantly better than the original nomogram according to likelihood ratio tests (p
Druh dokumentu: article
Popis súboru: electronic resource
Jazyk: English
ISSN: 2666-1683
Relation: http://www.sciencedirect.com/science/article/pii/S2666168325019500; https://doaj.org/toc/2666-1683
DOI: 10.1016/j.euros.2025.10.020
Prístupová URL adresa: https://doaj.org/article/7e4b51e2a2a94e5496f9735dc8204c7a
Prístupové číslo: edsdoj.7e4b51e2a2a94e5496f9735dc8204c7a
Databáza: Directory of Open Access Journals
Popis
Abstrakt:Background and objective: The aim of our study was to predict pathological lymph node involvement (stage pN1) in patients undergoing radical prostatectomy (RP) and extended pelvic lymph node dissection (ePLND) for prostate cancer (PC) and to compare the performance of nomograms used in ePLND decision-making. Methods: Data for 191 patients with PC who underwent and ePLND between 2018 and 2023 were analyzed retrospectively. Demographics, prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) results, and multiparametric magnetic resonance imaging (mpMRI) findings were assessed in relation to pN1 prediction and nomogram comparison. Statistical analyses included χ2 and Mann-Whitney U tests. New models in which PSMA PET/CT parameters (PRIMARY score, mean and maximum intraprostatic standardized uptake values) were incorporated in the Amsterdam-Brisbane-Sydney nomogram were evaluated using the area under the receiver operating characteristic curve (AUC) in a second analysis for a subset of 139 patients. The performance of the new models was analyzed using likelihood ratio tests. Key findings and limitations: In the primary cohort of 191 patients, 35 (18.3%) had stage pN1 at RP. AUC values were 0.751 (95% confidence interval [CI] 0.676–0.826) for the Briganti 2012 nomogram, 0.722 (95% CI 0.641–0.803) for the Briganti 2017 nomogram, 0.725 (95% CI 0.643–0.807) for the Memorial Sloan Kettering Cancer Center nomogram, and 0.862 (95% CI 0.794–0.929) for the Amsterdam-Brisbane-Sydney nomogram. In the second analysis for the subset of 139 patients, the PRIMARY score was significantly higher in the pN1 group (p = 0.011). The AUC for a new model incorporating the PRIMARY score in the Amsterdam-Brisbane-Sydney nomogram was 0.870 (95% CI 0.791–0.949), which surpasses AUC results for the other models. The performance of the newly developed models was significantly better than the original nomogram according to likelihood ratio tests (p
ISSN:26661683
DOI:10.1016/j.euros.2025.10.020