Predicting the risk of lymph node involvement using the pre-treatment prostate specific antigen and gleason score in men with clinically localized prostate cancer

Pelvic nodal dose escalation with prostate hypofractionation using conformal avoidance defined (H-CAD) intensity modulated radiation therapy

“…Tables [4] and formulas [5] employing clinical parameters have been commonly used to estimate the risk of lymph node disease, butemerging data based upon more comprehensive lymph node dissections suggest that these calculated risks of lymph node metastases may be underestimated [22,23]. These data suggest that a greater than previously appreciated proportion of PSA failures in post-prostatectomy or ''prostate-only'' RT patients (external beam or brachytherapy) may be due to unaddressed disease within the pelvic lymph nodes.…”

“…All patients had biopsy proven prostate cancer. Eligibility requirements mandated that definitive patients have a risk of lymph node metastasis exceeding 15% by standard nomograms [4,5] and post-operative patients had pre-operative criteria meeting lymph node risk ]/15% and biochemical failure. Staging with bone scan and CT of the abdomen and pelvis was performed to rule out radiographically apparent nodal or distant metastases.…”

Exploiting Machine Learning for Predicting Nodal Status in Prostate Cancer Patients

“…Even if some retrospective studies [23,24] showed a significant advantage in terms of biochemical control for patients having an extended primary tumor and a risk > 15% (estimated with Roach formula [22]), other retrospective studies, that specifically addressed to establish the role of the pelvic irradiation, [3,16,18] failed in showing any significant advantage in favour of the pelvic irradiation.…”

“…In order to help the clinician in the decision to treat or not pelvic nodes, many predictor tools have been proposed in the literature, most of them based on linear regression analyses [22,20,17]. One the most diffused methods to predict the SNM of prostate cancer patients is the Roach formula [22].…”

“…One the most diffused methods to predict the SNM of prostate cancer patients is the Roach formula [22]. The reason of its success is principally its simplicity, as it is based on only 2 parameters: the Gleason Score sum (GSsum) and the Prostate Specific Antigen (PSA) level.…”