Assessing the risk of lymph node invasion in patients with intermediate risk prostate cancer treated with extended pelvic lymph node dissection. A novel prediction tool

Briganti, Alberto; Capitanio, Umberto; Abdollah, Firas; Gallina, Andrea; Suardi, Nazareno; Bianchi, Marco; Tutolo, Manuela; Salonia, Andrea; Freschi, Massimo; Rigatti, Patrìzio; Montorsi, Francesco

doi:10.1002/pros.21451

Cited by 14 publications

(7 citation statements)

References 27 publications

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“…Although the risk of lymph node positivity in patients with intermediate risk disease is much lower than high risk disease, certain preoperative risk factors in intermediate risk patients can help guide surgeons on the likelihood of LNI. In a series of approximately 1,000 consecutive patients with intermediate risk disease, LNI was more commonly seen in patients with Gleason 7 disease and percentage of positive cores >63% (P<0.001) ( 22 ), irrespective of PSA value.…”

Section: Developing a Personalized Template For Lnd In Capmentioning

confidence: 99%

Developing a personalized template for lymph node dissection during radical prostatectomy

Pathak

Hemal

2018

Transl. Androl. Urol.

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Lymph node dissection (LND) represents a critical step in order to determine lymph node invasion (LNI), not only for prognostic means but also as a therapeutic strategy in the management of patients with prostate cancer (CaP). Indications for performing LND are inconsistent with the American Urologic Association (AUA), European Association of Urology (EAU), and National Comprehensive Cancer Network (NCCN) recommendations differing. A thorough appreciation of lymph node drainage patterns and extent of LND has reshaped our understanding of this disease. Moreover, newer research into this field has directly resulted in refinements to current nomograms with utilization of various prostate-specific antigen (PSA) parameters and genomic medicine. Lastly, the application of newer imaging modalities in combination with molecular-guided robotic surgery has personalized the approach of LND espousing excellent safety, efficacy, and oncologic outcomes in these patients.

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Section: Developing a Personalized Template For Lnd In Capmentioning

confidence: 99%

Developing a personalized template for lymph node dissection during radical prostatectomy

Pathak

Hemal

2018

Transl. Androl. Urol.

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“…Therefore, nomograms have been developed to predict the risk of lymph node invasion (LNI), allowing the identification of patients for which ePLND can be safety spared (i.e. patients with a low probability of positive ePLND) [6]. The European Association of Urology (EAU) guidelines recommend the use of the updated Briganti nomogram for intermediate-or high-risk PC patients, which is based on extended dissection.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic sentinel lymph node dissection in prostate cancer patients: the additional value depends on preoperative data

Rousseau

Mathieu

et al. 2016

Eur J Nucl Med Mol Imaging

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“…CART models have been used previously for prognosis classification in cancer and other diseases. 14 – 16 Various studies have performed CART analysis in colorectal cancer patients to search for biomarkers highly predictive of response to therapy in order to select patients for treatment 17 – 19 or to select genes for phenotypic classification. 20 , 21 However, to our knowledge, there are no validated prediction models, including CART models, for medium-term mortality among patients with colon cancer.…”

Section: Introductionmentioning

confidence: 99%

Combining statistical techniques to predict postsurgical risk of 1-year mortality for patients with colon cancer

Aróstegui¹,

González²,

Fernández-de-Larrea³

et al. 2018

CLEP

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IntroductionColorectal cancer is one of the most frequently diagnosed malignancies and a common cause of cancer-related mortality. The aim of this study was to develop and validate a clinical predictive model for 1-year mortality among patients with colon cancer who survive for at least 30 days after surgery.MethodsPatients diagnosed with colon cancer who had surgery for the first time and who survived 30 days after the surgery were selected prospectively. The outcome was mortality within 1 year. Random forest, genetic algorithms and classification and regression trees were combined in order to identify the variables and partition points that optimally classify patients by risk of mortality. The resulting decision tree was categorized into four risk categories. Split-sample and bootstrap validation were performed. ClinicalTrials.gov Identifier: NCT02488161.ResultsA total of 1945 patients were enrolled in the study. The variables identified as the main predictors of 1-year mortality were presence of residual tumor, American Society of Anesthesiologists Physical Status Classification System risk score, pathologic tumor staging, Charlson Comorbidity Index, intraoperative complications, adjuvant chemotherapy and recurrence of tumor. The model was internally validated; area under the receiver operating characteristic curve (AUC) was 0.896 in the derivation sample and 0.835 in the validation sample. Risk categorization leads to AUC values of 0.875 and 0.832 in the derivation and validation samples, respectively. Optimal cut-off point of estimated risk had a sensitivity of 0.889 and a specificity of 0.758.ConclusionThe decision tree was a simple, interpretable, valid and accurate prediction rule of 1-year mortality among colon cancer patients who survived for at least 30 days after surgery.

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Assessing the risk of lymph node invasion in patients with intermediate risk prostate cancer treated with extended pelvic lymph node dissection. A novel prediction tool

Abstract: The risk of having LNI varies significantly (3.7–20.1%) in patients with intermediate risk PCa. Our predictive tool might help selecting those patients suitable fore PLND, allowing to spare this approach in about 60% of intermediate risk patients.

Cited by 14 publications

References 27 publications

Developing a personalized template for lymph node dissection during radical prostatectomy

Developing a personalized template for lymph node dissection during radical prostatectomy

Laparoscopic sentinel lymph node dissection in prostate cancer patients: the additional value depends on preoperative data

Combining statistical techniques to predict postsurgical risk of 1-year mortality for patients with colon cancer

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