A Nomogram for Predicting Prostate Cancer with Lymph Node Involvement in Robot-Assisted Radical Prostatectomy Era: A Retrospective Multicenter Cohort Study in Japan (The MSUG94 Group)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Population
2.2. Pathological Analysis
2.3. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Development of a Clinically Applicable Nomogram Predicting PCa with Lymph Node Involvement
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | |
---|---|
Age (year, median, IQR) | 68 (64–72) |
Body mass index (median, IQR) | 23.7 (21.8–25.7) |
ECOG Performance Status (number, %) | |
0 | 1800 (97.0) |
1 | 51 (2.7) |
2 | 4 (0.2) |
Initial PSA (ng/mL, median, IQR) | 8.1 (5.8–12.2) |
Prostate volume (cc, median, IQR) | 30.0 (22.8–39.4) |
Number of biopsy cores (median, IQR) | 10 (10–13) |
Number of positive cores (median, IQR) | 4 (2–5) |
Number of negative cores (median, IQR) | 8 (6–10) |
Biopsy Gleason Grade (number, %) 1 2 3 4 5 | 182 (9.8) 572 (30.8) 442 (23.8) 488 (26.3) 171 (9.2) |
Clinical T stage (number, %) | |
T1c | 326 (17.6) |
T2a | 770 (41.5) |
T2b | 198 (10.7) |
T2c | 364 (19.6) |
T3a | 179 (9.7) |
T3b | 18 (1.0) |
Hemoglobin (g/dL, median, IQR) | 14.5 (13.8–15.2) |
C-reactive protein (mg/dL, median, IQR) | 0.06 (0.03–0.11) |
NLR (median, IQR) | 2.01 (1.52–2.71) |
PLR (median, IQR) | 125 (97.1–163) |
SII (median, IQR) | 417 (294–579) |
Pelvic lymphadenectomy (number, %) Limited Standard Extended | 1312 (70.7) 214 (11.5) 320 (17.3) |
Removed and examined lymph nodes count (median, IQR) | 7 (4–11) |
Pathological Gleason Grade (number, %) 1 2 3 4 5 | 182 (9.8) 572 (30.8) 442 (23.8) 488 (26.3) 171 (9.2) |
Pathological T stage (number, %) T2 T3 T4 | 1206 (65.0) 641 (34.6) 7 (0.4) |
Positive surgical margin (number, %) | 632 (34.1) |
Lymph node involvement (number, %) | 93 (5.0) |
Variables | Odds Ratio | 95% Confidence Interval | p Value |
---|---|---|---|
Age | 1.02 | 0.75–1.38 | 0.910 |
Body mass index | 0.95 | 0.69–1.30 | 0.748 |
ECOG-PS | 2.19 | 0.26–18.52 | 0.470 |
Initial PSA | 1.25 | 1.11–1.40 | <0.001 |
Prostate volume | 1.08 | 0.82–1.41 | 0.58 |
Number of positive cores | 1.43 | 1.13–1.80 | 0.003 |
Number of negative cores | 0.80 | 0.59–1.09 | 0.156 |
Biopsy Gleason Grade | 3.17 | 2.02–4.99 | <0.001 |
Clinical T stage 2a † | 4.59 | 1.07–19.6 | 0.04 |
Clinical T stage 2b † | 5.32 | 1.14–24.8 | 0.003 |
Clinical T stage 2c † | 1.75 | 0.37–8.43 | 0.483 |
Clinical T stage 3a † | 10.05 | 2.27–44.47 | 0.002 |
Clinical T stage 3b † | 24.71 | 4.06–150.29 | <0.001 |
Hemoglobin | 1.03 | 0.77–1.38 | 0.853 |
C-reactive protein | 0.98 | 0.69–1.30 | 0.748 |
NLR | 0.93 | 0.59–1.48 | 0.765 |
PLR | 1.00 | 0.67–1.50 | 0.999 |
SII | 0.98 | 0.67–1.44 | 0.909 |
Nomogram Cutoff | Patient below Cutoff with pN1 | Patient below Cutoff with pN0 | Negative Predictive Value |
---|---|---|---|
6% | 2 | 492 | 99.6% |
10% | 8 | 767 | 99.0% |
15% | 16 | 1041 | 98.5% |
20% | 23 | 1227 | 98.2% |
25% | 30 | 1362 | 97.8% |
30% | 39 | 1466 | 97.4% |
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Kawase, M.; Ebara, S.; Tatenuma, T.; Sasaki, T.; Ikehata, Y.; Nakayama, A.; Toide, M.; Yoneda, T.; Sakaguchi, K.; Ishihara, T.; et al. A Nomogram for Predicting Prostate Cancer with Lymph Node Involvement in Robot-Assisted Radical Prostatectomy Era: A Retrospective Multicenter Cohort Study in Japan (The MSUG94 Group). Diagnostics 2022, 12, 2545. https://doi.org/10.3390/diagnostics12102545
Kawase M, Ebara S, Tatenuma T, Sasaki T, Ikehata Y, Nakayama A, Toide M, Yoneda T, Sakaguchi K, Ishihara T, et al. A Nomogram for Predicting Prostate Cancer with Lymph Node Involvement in Robot-Assisted Radical Prostatectomy Era: A Retrospective Multicenter Cohort Study in Japan (The MSUG94 Group). Diagnostics. 2022; 12(10):2545. https://doi.org/10.3390/diagnostics12102545
Chicago/Turabian StyleKawase, Makoto, Shin Ebara, Tomoyuki Tatenuma, Takeshi Sasaki, Yoshinori Ikehata, Akinori Nakayama, Masahiro Toide, Tatsuaki Yoneda, Kazushige Sakaguchi, Takuma Ishihara, and et al. 2022. "A Nomogram for Predicting Prostate Cancer with Lymph Node Involvement in Robot-Assisted Radical Prostatectomy Era: A Retrospective Multicenter Cohort Study in Japan (The MSUG94 Group)" Diagnostics 12, no. 10: 2545. https://doi.org/10.3390/diagnostics12102545