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Yonsei nomogram to predict lymph node invasion in Asian men with prostate cancer during robotic era

Authors
 Kwang Hyun Kim  ;  Sey Kiat Lim  ;  Ha Yan Kim  ;  Woong Kyu Han  ;  Young Deuk Choi  ;  Byung Ha Chung  ;  Sung Joon Hong  ;  Koon Ho Rha 
Citation
 BJU INTERNATIONAL, Vol.113(4) : 598-604, 2014 
Journal Title
 BJU INTERNATIONAL 
ISSN
 1464-4096 
Issue Date
2014
MeSH
Aged ; Asia/ethnology ; Humans ; Lymph Node Excision/methods ; Lymph Node Excision/statistics & numerical data ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Grading ; Nomograms* ; Prospective Studies ; Prostate-Specific Antigen/blood ; Prostatectomy/methods* ; Prostatic Neoplasms/blood ; Prostatic Neoplasms/ethnology ; Prostatic Neoplasms/pathology* ; Prostatic Neoplasms/surgery ; Robotics/methods* ; Robotics/statistics & numerical data
Keywords
lymph node excision ; nomograms ; prostatectomy ; prostatic neoplasm
Abstract
OBJECTIVE: To develop a novel nomogram to predict lymph node invasion (LNI) in Asian men undergoing radical prostatectomy (RP) and pelvic LN dissection (PLND) for localised prostate cancer. PATIENTS AND METHODS: The patient cohort included 541 patients who underwent robot-assisted RP and PLND by a single surgeon between January 2008 and December 2011. Patients with dissection of <10 LNs, prostate-specific antigen (PSA) levels of >50 ng/mL, incomplete biopsy data, and treatment with neoadjuvant therapy were excluded. RESULTS: The median (interquartile range) number of LNs removed was 17 (14-22) and 45 patients (8.3%) had LN metastases. On multivariate logistic regression analysis, PSA level, clinical stage and Gleason score were independent predictors of LNI. The bootstrap corrected area under curve of the model incorporating PSA level, clinical stage, and biopsy Gleason score was 0.883. With a cutoff value of 4%, PLND could be omitted in 326 patients (60.2%), missing only two patients (4.4%) with LNI. The sensitivity, specificity, positive predictive value and negative predictive value were 95.6%, 65.3%, 20.0% and 99.4%, respectively. CONCLUSIONS: We report a nomogram to predict LNI in Asian men with prostate cancer. The model demonstrated high accuracy and could be used for counselling patients and the selection of candidates for PLND.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/bju.12280/abstract
DOI
10.1111/bju.12280
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Ha Yan(김하얀)
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Lim, Sey Kiat(임세이캣)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Han, Woong Kyu(한웅규) ORCID logo https://orcid.org/0000-0002-2527-4046
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98386
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