Abstract：
To determine candidates for extended pelvic lymph node dissection using a novel nomogram to assess the risk of lymph node invasion in Japanese prostate cancer patients in the robotic era.
A total of 538 patients who underwent robot-assisted radical prostatectomy with extended pelvic lymph node dissection in three hospitals were retrospectively analyzed. Medical records were reviewed uniformly and the following data collected: prostate-specific antigen, age, clinical T stage, primary and secondary Gleason score at prostate biopsy, and percentage of positive core numbers. Finally, data from 434 patients were used for developing the nomogram and data from 104 patients were used for external validation.
Lymph node invasion was detected in 47 (11%) and 16 (15%) patients in the development and validation set, respectively. Based on multivariate analysis, prostate-specific antigen, clinical T stage ≥3, primary Gleason score, grade group 5, and percentage of positive cores were selected as variables to incorporate into the nomogram. The area under the curve values were 0.781 for the internal and 0.908 for the external validation, respectively.
The present nomogram can help urologists identify candidates for extended pelvic lymph node dissection concomitant with robot-assisted radical prostatectomy among patients with prostate cancer.
A total of 538 patients who underwent robot-assisted radical prostatectomy with extended pelvic lymph node dissection in three hospitals were retrospectively analyzed. Medical records were reviewed uniformly and the following data collected: prostate-specific antigen, age, clinical T stage, primary and secondary Gleason score at prostate biopsy, and percentage of positive core numbers. Finally, data from 434 patients were used for developing the nomogram and data from 104 patients were used for external validation.
Lymph node invasion was detected in 47 (11%) and 16 (15%) patients in the development and validation set, respectively. Based on multivariate analysis, prostate-specific antigen, clinical T stage ≥3, primary Gleason score, grade group 5, and percentage of positive cores were selected as variables to incorporate into the nomogram. The area under the curve values were 0.781 for the internal and 0.908 for the external validation, respectively.
The present nomogram can help urologists identify candidates for extended pelvic lymph node dissection concomitant with robot-assisted radical prostatectomy among patients with prostate cancer.
摘要：
目的：使用新的列线图来评估机器人时代日本前列腺癌患者淋巴结侵犯的风险，以确定扩大盆腔淋巴结清扫的候选人。
方法：回顾性分析3家医院接受机器人辅助前列腺癌根治术伴盆腔淋巴结清扫的538例患者。统一审查了医疗记录，并收集了以下数据：前列腺特异性抗原，年龄,临床T分期,前列腺活检的主要和次要Gleason评分，和正核心数字的百分比。最后,来自434例患者的数据用于建立列线图,来自104例患者的数据用于外部验证.
结果：在开发和验证组中，在47例（11%）和16例（15%）患者中检测到淋巴结侵犯，分别。基于多变量分析，前列腺特异性抗原,临床T分期≥3，原发性Gleason评分，第5级,选择阳性核心百分比作为纳入列线图的变量.内部验证的曲线下面积值为0.781，外部验证为0.908，分别。
结论：本列线图可帮助泌尿科医师在前列腺癌患者中确定盆腔淋巴结清扫扩大并机器人辅助前列腺癌根治术的候选方案。
方法：回顾性分析3家医院接受机器人辅助前列腺癌根治术伴盆腔淋巴结清扫的538例患者。统一审查了医疗记录，并收集了以下数据：前列腺特异性抗原，年龄,临床T分期,前列腺活检的主要和次要Gleason评分，和正核心数字的百分比。最后,来自434例患者的数据用于建立列线图,来自104例患者的数据用于外部验证.
结果：在开发和验证组中，在47例（11%）和16例（15%）患者中检测到淋巴结侵犯，分别。基于多变量分析，前列腺特异性抗原,临床T分期≥3，原发性Gleason评分，第5级,选择阳性核心百分比作为纳入列线图的变量.内部验证的曲线下面积值为0.781，外部验证为0.908，分别。
结论：本列线图可帮助泌尿科医师在前列腺癌患者中确定盆腔淋巴结清扫扩大并机器人辅助前列腺癌根治术的候选方案。
