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Comparison of nomograms predicting lymph node invasion in patients undergoing radical prostatectomy for prostate cancer

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Abstract

Introduction

The aim of this study was to compare the performance of preoperative risk nomograms or detecting lymph node invasion in a cohort of men undergoing radical prostatectomy (RP).

Methods

A retrospective analysis was performed on all men (n = 145) who underwent RP between 2012 and 2015. Preoperative data was inputted to the Memorial Sloan-Kettering Cancer Centre (MSKCC), Partin 2011 and Briganti nomograms and the University of California San Francisco- Centre of the Prostate Risk Assessment tool (UCSF-CAPRA). The risk of lymph node involvement (LNI) was calculated and compared to final histology.

Results

One hundred three (71%) men underwent a lymph node dissection at RP. Ten (9.7%) demonstrated LNI. The median nodal yield was 15 nodes, with no difference between those with LNI and those without (19.5 vs 14.5, p = 0.22).No patient classified as low risk on the UCSF-CAPRA score had evidence of LNI. In patients with LNI, no patient breached the 2% threshold for lymph node dissection (LND) on the MSKCC nomogram; four patients breached the 5% threshold on the Partin tables while three patients breached the 2.5% threshold for the Briganti nomogram.

Conclusion

Nomograms produce useful information regarding risk of disease; however, they often have not been validated on different populations. Risk predictions need to be considered carefully and treatment decisions were made on a patient specific basis.

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Authors and Affiliations

  1. Department of Urology, Cork University Hospital, Wilton, Cork, Ireland

    G. J. Nason, E. M. O’Connor, B. Moss, S. W. Considine, A. Cahill & F. M. O’Brien

  2. Department of Urology, University Hospital Waterford, Waterford, Ireland

    D. MacMahon, C. O’Rourke & F. M. O’Brien

Authors
  1. G. J. Nason
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  2. E. M. O’Connor
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  3. D. MacMahon
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  4. B. Moss
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  5. S. W. Considine
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  6. A. Cahill
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  7. C. O’Rourke
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  8. F. M. O’Brien
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Correspondence to G. J. Nason.

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Nason, G.J., O’Connor, E.M., MacMahon, D. et al. Comparison of nomograms predicting lymph node invasion in patients undergoing radical prostatectomy for prostate cancer. Ir J Med Sci 187, 33–37 (2018). https://doi.org/10.1007/s11845-017-1626-8

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  • DOI: https://doi.org/10.1007/s11845-017-1626-8

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