A Nomogram for Predicting Pelvic Lymph Node Metastasis in Prostate Cancer

Xu Yang; Chen Rui; Li Shuofeng; Zhang Chi; Zheng Yuxin; Li Wang

doi:doi:10.11648/j.ijcu.20220601.13

| Peer-Reviewed

A Nomogram for Predicting Pelvic Lymph Node Metastasis in Prostate Cancer

Xu Yang, Chen Rui, Li Shuofeng, Zhang Chi, Zheng Yuxin, Li Wang

Published in International Journal of Clinical Urology (Volume 6, Issue 1)

Received: 25 December 2021 Accepted: 19 January 2022 Published: 26 January 2022

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: Prostate cancer (PCa) is prone to lymph node metastasis. In this report, the authors described a model predictive of the probability of lymph node metastasis in prostate cancer patients. Methods: Two-hundred seventy-eight middle-high-risk PCa patients who received laparoscopic radical prostatectomy (LRP) combined with extended pelvic lymph node dissection (e-PLND) in our hospital were selected as the subjects and the authors performed a retrospective analysis. According to the postoperative pathological results, the patients were divided into a pelvic lymph node metastasis group (n=100) and a non-pelvic lymph node metastasis group (n=178). Univariable and multivariable logistic regression analyses were performed to identify independent risk factors for pelvic lymph node metastasis from PCa. Finally, a clinical prediction model nomogram was further established and verified, and a calibration plot was drawn to verify the accuracy of the model. Results: The TPSA level, FPSA level, PI-RADS score, biopsy ISUP classification and Gleason score of the two groups were statistically different (P<0.05), and there was no statistical difference between the age groups (P>0.05). Receiver operating characteristic curve (ROC) showed that the best diagnostic cut-off value of TPSA was 77.45 ng/ml (AUC=0.785, 95%CI: 0.729-0.842), and the best diagnostic cut-off value of FPSA was 0.085 ng/ml (AUC=0.282, 95%CI: 0.215-0.348). Univariable and multivariable logistic regression analyses showed that, TPSA level (OR=1.00, 95%Cl: 1.000-1.006, P<0.05), FPSA level (OR=0.00, 95%Cl: 0.000-0.089, P<0.01), PI-RADS score (OR=9.26, 95%CI: 5.278-16.248, P<0.01) and biopsy ISUP grade (OR=1.69, 95%CI: 1.163-2.450, P<0.01) were independent predictors of pelvic lymph node metastasis. Conclusions: The nomogram established in this study has a good predictive ability for pelvic lymph node metastasis in patients with PCa, and can provide a reference for the selection of clinical treatment options.

Published in	International Journal of Clinical Urology (Volume 6, Issue 1)
DOI	10.11648/j.ijcu.20220601.13
Page(s)	10-14
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Prostate Cancer, Pelvic Lymph Node Metastasis, Risk Factors, Nomogram

References

[1]	WILCZAK W, WITTMER C, CLAUDITZ T, et al. Marked Prognostic Impact of Minimal Lymphatic Tumor Spread in Prostate Cancer [J]. European urology, 2018, 74 (3): 376-386. DOI: 10.1016/j.eururo.2018.05.034.
[2]	WOLF J S, JR., CHER M, DALL'ERA M, et al. The use and accuracy of cross-sectional imaging and fine needle aspiration cytology for detection of pelvic lymph node metastases before radical prostatectomy [J]. The Journal of urology, 1995, 153 (3 Pt 2): 993-999. PMID- 7853590.
[3]	KATZ S, ROSEN M. MR imaging and MR spectroscopy in prostate cancer management [J]. Radiologic clinics of North America, 2006, 44 (5): 723-734, viii. DOI: 10.1016/j.rcl.2006.07.008.
[4]	TEMPANY C M, MCNEIL B J. Advances in biomedical imaging [J]. Jama, 2001, 285 (5): 562-567. DOI: 10.1001/jama.285.5.562.
[5]	CHAN T Y, PARTIN A W, WALSH P C, et al. Prognostic significance of Gleason score 3+4 versus Gleason score 4+3 tumor at radical prostatectomy [J]. Urology, 2000, 56 (5): 823-827. DOI: 10.1016/s0090-4295(00)00753-6.
[6]	STARK J R, PERNER S, STAMPFER M J, et al. Gleason score and lethal prostate cancer: does 3 + 4=4 + 3? [J]. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 2009, 27 (21): 3459-3464. DOI: 10.1200/JCO.2008.20.4669.
[7]	O'BRIEN B A, COHEN R J, WHEELER T M, et al. A post-radical-prostatectomy nomogram incorporating new pathological variables and interaction terms for improved prognosis [J]. BJU international, 2011, 107 (3): 389-395. DOI: 10.1200/JCO.2012.41.5984.
[8]	WANG Y, LI J, XIA Y, et al. Prognostic nomogram for intrahepatic cholangiocarcinoma after partial hepatectomy [J]. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 2013, 31 (9): 1188-1195. DOI: 10.21037/jtd.2018.03.126.
[9]	YANG X, PAN X, LIU H, et al. A new approach to predict lymph node metastasis in solid lung adenocarcinoma: a radiomics nomogram [J]. Journal of thoracic disease, 2018, 10 (Suppl 7): S807-s19. DOI: 10.1111/j.1464-410X.2010.09539.x.
[10]	DANIYAL M, SIDDIQUI Z A, AKRAM M, et al. Epidemiology, etiology, diagnosis and treatment of prostate cancer [J]. Asian Pacific journal of cancer prevention: APJCP, 2014, 15 (22): 9575-9578. DOI: 10.7314/apjcp.2014.15.22.9575.
[11]	DANESHMAND S, QUEK M L, STEIN J P, et al. Prognosis of patients with lymph node positive prostate cancer following radical prostatectomy: long-term results [J]. The Journal of urology, 2004, 172 (6 Pt 1): 2252-2255. DOI: 10.1097/01.ju.0000143448.04161.cc.
[12]	MOTTET N, BELLMUNT J, BOLLA M, et al. EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent [J]. European urology, 2017, 71 (4): 618-629. DOI: 10.1016/j.crad.2007.05.022.
[13]	PLOUSSARD G, BRIGANTI A, DE LA TAILLE A, et al. Pelvic lymph node dissection during robot-assisted radical prostatectomy: efficacy, limitations, and complications-a systematic review of the literature [J]. European urology, 2014, 65 (1): 7-16. DOI: 10.1016/j.eururo.2016.08.003.
[14]	FOSSATI N, WILLEMSE P M, VAN DEN BROECK T, et al. The Benefits and Harms of Different Extents of Lymph Node Dissection During Radical Prostatectomy for Prostate Cancer: A Systematic Review [J]. European urology, 2017, 72 (1): 84-109. DOI: 10.1016/j.eururo.2013.03.057.
[15]	HöVELS A M, HEESAKKERS R A, ADANG E M, et al. The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis [J]. Clinical radiology, 2008, 63 (4): 387-395. DOI: 10.1016/j.eururo.2016.12.003.
[16]	CIMINO S, REALE G, CASTELLI T, et al. Comparison between Briganti, Partin and MSKCC tools in predicting positive lymph nodes in prostate cancer: a systematic review and meta-analysis [J]. Scand J Urol, 2017, 51 (5): 345-350. DOI: 10.1080/21681805.2017.1332680.
[17]	ZANELLI E, GIANNARINI G, CERESER L, et al. Head-to-head comparison between multiparametric MRI, the partin tables, memorial sloan kettering cancer center nomogram, and CAPRA score in predicting extraprostatic cancer in patients undergoing radical prostatectomy [J]. J Magn Reson Imaging, 2019, 50 (5): 1604-1613. DOI: 10.1002/jmri.26743.
[18]	BANDINI M, FOSSATI N, GANDAGLIA G, et al. Neoadjuvant and adjuvant treatment in high-risk prostate cancer [J]. Expert Rev Clin Pharmacol, 2018, 11 (4): 425-438. DOI: 10.1080/17512433.2018.1429265.

Cite This Article

Plain Text BibTeX RIS

APA Style

Xu Yang, Chen Rui, Li Shuofeng, Zhang Chi, Zheng Yuxin, et al. (2022). A Nomogram for Predicting Pelvic Lymph Node Metastasis in Prostate Cancer. International Journal of Clinical Urology, 6(1), 10-14. https://doi.org/10.11648/j.ijcu.20220601.13

Copy | Download

ACS Style

Xu Yang; Chen Rui; Li Shuofeng; Zhang Chi; Zheng Yuxin, et al. A Nomogram for Predicting Pelvic Lymph Node Metastasis in Prostate Cancer. Int. J. Clin. Urol. 2022, 6(1), 10-14. doi: 10.11648/j.ijcu.20220601.13

Copy | Download

AMA Style

Xu Yang, Chen Rui, Li Shuofeng, Zhang Chi, Zheng Yuxin, et al. A Nomogram for Predicting Pelvic Lymph Node Metastasis in Prostate Cancer. Int J Clin Urol. 2022;6(1):10-14. doi: 10.11648/j.ijcu.20220601.13

Copy | Download

@article{10.11648/j.ijcu.20220601.13,
  author = {Xu Yang and Chen Rui and Li Shuofeng and Zhang Chi and Zheng Yuxin and Li Wang},
  title = {A Nomogram for Predicting Pelvic Lymph Node Metastasis in Prostate Cancer},
  journal = {International Journal of Clinical Urology},
  volume = {6},
  number = {1},
  pages = {10-14},
  doi = {10.11648/j.ijcu.20220601.13},
  url = {https://doi.org/10.11648/j.ijcu.20220601.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20220601.13},
  abstract = {Background: Prostate cancer (PCa) is prone to lymph node metastasis. In this report, the authors described a model predictive of the probability of lymph node metastasis in prostate cancer patients. Methods: Two-hundred seventy-eight middle-high-risk PCa patients who received laparoscopic radical prostatectomy (LRP) combined with extended pelvic lymph node dissection (e-PLND) in our hospital were selected as the subjects and the authors performed a retrospective analysis. According to the postoperative pathological results, the patients were divided into a pelvic lymph node metastasis group (n=100) and a non-pelvic lymph node metastasis group (n=178). Univariable and multivariable logistic regression analyses were performed to identify independent risk factors for pelvic lymph node metastasis from PCa. Finally, a clinical prediction model nomogram was further established and verified, and a calibration plot was drawn to verify the accuracy of the model. Results: The TPSA level, FPSA level, PI-RADS score, biopsy ISUP classification and Gleason score of the two groups were statistically different (P0.05). Receiver operating characteristic curve (ROC) showed that the best diagnostic cut-off value of TPSA was 77.45 ng/ml (AUC=0.785, 95%CI: 0.729-0.842), and the best diagnostic cut-off value of FPSA was 0.085 ng/ml (AUC=0.282, 95%CI: 0.215-0.348). Univariable and multivariable logistic regression analyses showed that, TPSA level (OR=1.00, 95%Cl: 1.000-1.006, PConclusions: The nomogram established in this study has a good predictive ability for pelvic lymph node metastasis in patients with PCa, and can provide a reference for the selection of clinical treatment options.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - A Nomogram for Predicting Pelvic Lymph Node Metastasis in Prostate Cancer
AU  - Xu Yang
AU  - Chen Rui
AU  - Li Shuofeng
AU  - Zhang Chi
AU  - Zheng Yuxin
AU  - Li Wang
Y1  - 2022/01/26
PY  - 2022
N1  - https://doi.org/10.11648/j.ijcu.20220601.13
DO  - 10.11648/j.ijcu.20220601.13
T2  - International Journal of Clinical Urology
JF  - International Journal of Clinical Urology
JO  - International Journal of Clinical Urology
SP  - 10
EP  - 14
PB  - Science Publishing Group
SN  - 2640-1355
UR  - https://doi.org/10.11648/j.ijcu.20220601.13
AB  - Background: Prostate cancer (PCa) is prone to lymph node metastasis. In this report, the authors described a model predictive of the probability of lymph node metastasis in prostate cancer patients. Methods: Two-hundred seventy-eight middle-high-risk PCa patients who received laparoscopic radical prostatectomy (LRP) combined with extended pelvic lymph node dissection (e-PLND) in our hospital were selected as the subjects and the authors performed a retrospective analysis. According to the postoperative pathological results, the patients were divided into a pelvic lymph node metastasis group (n=100) and a non-pelvic lymph node metastasis group (n=178). Univariable and multivariable logistic regression analyses were performed to identify independent risk factors for pelvic lymph node metastasis from PCa. Finally, a clinical prediction model nomogram was further established and verified, and a calibration plot was drawn to verify the accuracy of the model. Results: The TPSA level, FPSA level, PI-RADS score, biopsy ISUP classification and Gleason score of the two groups were statistically different (P0.05). Receiver operating characteristic curve (ROC) showed that the best diagnostic cut-off value of TPSA was 77.45 ng/ml (AUC=0.785, 95%CI: 0.729-0.842), and the best diagnostic cut-off value of FPSA was 0.085 ng/ml (AUC=0.282, 95%CI: 0.215-0.348). Univariable and multivariable logistic regression analyses showed that, TPSA level (OR=1.00, 95%Cl: 1.000-1.006, PConclusions: The nomogram established in this study has a good predictive ability for pelvic lymph node metastasis in patients with PCa, and can provide a reference for the selection of clinical treatment options.
VL  - 6
IS  - 1
ER  -

Copy | Download

Author Information

Xu Yang

Department of Urology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
Chen Rui

Department of Urology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
Li Shuofeng

Department of Urology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
Zhang Chi

Department of Urology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
Zheng Yuxin

Department of Urology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
Li Wang

Department of Urology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Xu Yang, Chen Rui, Li Shuofeng, Zhang Chi, Zheng Yuxin, et al. (2022). A Nomogram for Predicting Pelvic Lymph Node Metastasis in Prostate Cancer. International Journal of Clinical Urology, 6(1), 10-14. https://doi.org/10.11648/j.ijcu.20220601.13

Copy | Download

ACS Style

Xu Yang; Chen Rui; Li Shuofeng; Zhang Chi; Zheng Yuxin, et al. A Nomogram for Predicting Pelvic Lymph Node Metastasis in Prostate Cancer. Int. J. Clin. Urol. 2022, 6(1), 10-14. doi: 10.11648/j.ijcu.20220601.13

Copy | Download

AMA Style

Xu Yang, Chen Rui, Li Shuofeng, Zhang Chi, Zheng Yuxin, et al. A Nomogram for Predicting Pelvic Lymph Node Metastasis in Prostate Cancer. Int J Clin Urol. 2022;6(1):10-14. doi: 10.11648/j.ijcu.20220601.13

Copy | Download

@article{10.11648/j.ijcu.20220601.13,
  author = {Xu Yang and Chen Rui and Li Shuofeng and Zhang Chi and Zheng Yuxin and Li Wang},
  title = {A Nomogram for Predicting Pelvic Lymph Node Metastasis in Prostate Cancer},
  journal = {International Journal of Clinical Urology},
  volume = {6},
  number = {1},
  pages = {10-14},
  doi = {10.11648/j.ijcu.20220601.13},
  url = {https://doi.org/10.11648/j.ijcu.20220601.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20220601.13},
  abstract = {Background: Prostate cancer (PCa) is prone to lymph node metastasis. In this report, the authors described a model predictive of the probability of lymph node metastasis in prostate cancer patients. Methods: Two-hundred seventy-eight middle-high-risk PCa patients who received laparoscopic radical prostatectomy (LRP) combined with extended pelvic lymph node dissection (e-PLND) in our hospital were selected as the subjects and the authors performed a retrospective analysis. According to the postoperative pathological results, the patients were divided into a pelvic lymph node metastasis group (n=100) and a non-pelvic lymph node metastasis group (n=178). Univariable and multivariable logistic regression analyses were performed to identify independent risk factors for pelvic lymph node metastasis from PCa. Finally, a clinical prediction model nomogram was further established and verified, and a calibration plot was drawn to verify the accuracy of the model. Results: The TPSA level, FPSA level, PI-RADS score, biopsy ISUP classification and Gleason score of the two groups were statistically different (P0.05). Receiver operating characteristic curve (ROC) showed that the best diagnostic cut-off value of TPSA was 77.45 ng/ml (AUC=0.785, 95%CI: 0.729-0.842), and the best diagnostic cut-off value of FPSA was 0.085 ng/ml (AUC=0.282, 95%CI: 0.215-0.348). Univariable and multivariable logistic regression analyses showed that, TPSA level (OR=1.00, 95%Cl: 1.000-1.006, PConclusions: The nomogram established in this study has a good predictive ability for pelvic lymph node metastasis in patients with PCa, and can provide a reference for the selection of clinical treatment options.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - A Nomogram for Predicting Pelvic Lymph Node Metastasis in Prostate Cancer
AU  - Xu Yang
AU  - Chen Rui
AU  - Li Shuofeng
AU  - Zhang Chi
AU  - Zheng Yuxin
AU  - Li Wang
Y1  - 2022/01/26
PY  - 2022
N1  - https://doi.org/10.11648/j.ijcu.20220601.13
DO  - 10.11648/j.ijcu.20220601.13
T2  - International Journal of Clinical Urology
JF  - International Journal of Clinical Urology
JO  - International Journal of Clinical Urology
SP  - 10
EP  - 14
PB  - Science Publishing Group
SN  - 2640-1355
UR  - https://doi.org/10.11648/j.ijcu.20220601.13
AB  - Background: Prostate cancer (PCa) is prone to lymph node metastasis. In this report, the authors described a model predictive of the probability of lymph node metastasis in prostate cancer patients. Methods: Two-hundred seventy-eight middle-high-risk PCa patients who received laparoscopic radical prostatectomy (LRP) combined with extended pelvic lymph node dissection (e-PLND) in our hospital were selected as the subjects and the authors performed a retrospective analysis. According to the postoperative pathological results, the patients were divided into a pelvic lymph node metastasis group (n=100) and a non-pelvic lymph node metastasis group (n=178). Univariable and multivariable logistic regression analyses were performed to identify independent risk factors for pelvic lymph node metastasis from PCa. Finally, a clinical prediction model nomogram was further established and verified, and a calibration plot was drawn to verify the accuracy of the model. Results: The TPSA level, FPSA level, PI-RADS score, biopsy ISUP classification and Gleason score of the two groups were statistically different (P0.05). Receiver operating characteristic curve (ROC) showed that the best diagnostic cut-off value of TPSA was 77.45 ng/ml (AUC=0.785, 95%CI: 0.729-0.842), and the best diagnostic cut-off value of FPSA was 0.085 ng/ml (AUC=0.282, 95%CI: 0.215-0.348). Univariable and multivariable logistic regression analyses showed that, TPSA level (OR=1.00, 95%Cl: 1.000-1.006, PConclusions: The nomogram established in this study has a good predictive ability for pelvic lymph node metastasis in patients with PCa, and can provide a reference for the selection of clinical treatment options.
VL  - 6
IS  - 1
ER  -

Copy | Download