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Clinical nodal staging scores for prostate cancer: a proposal for preoperative risk assessment

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Clinical nodal staging scores for prostate cancer: a proposal for preoperative risk assessment. / Kluth, L A; Abdollah, F; Xylinas, E; Rieken, M; Fajkovic, H; Seitz, C; Sun, M; Karakiewicz, P I; Schramek, P; Herman, M P; Becker, A; Hansen, J; Ehdaie, B; Loidl, W; Pummer, K; Lee, R K; Lotan, Y; Scherr, D S; Seiler, D; Ahyai, S A; Chun, F K-H; Graefen, M; Tewari, A; Nonis, A; Bachmann, A; Montorsi, F; Gönen, M; Briganti, A; Shariat, S F.

In: BRIT J CANCER, Vol. 111, No. 2, 15.07.2014, p. 213-219.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Kluth, LA, Abdollah, F, Xylinas, E, Rieken, M, Fajkovic, H, Seitz, C, Sun, M, Karakiewicz, PI, Schramek, P, Herman, MP, Becker, A, Hansen, J, Ehdaie, B, Loidl, W, Pummer, K, Lee, RK, Lotan, Y, Scherr, DS, Seiler, D, Ahyai, SA, Chun, FK-H, Graefen, M, Tewari, A, Nonis, A, Bachmann, A, Montorsi, F, Gönen, M, Briganti, A & Shariat, SF 2014, 'Clinical nodal staging scores for prostate cancer: a proposal for preoperative risk assessment', BRIT J CANCER, vol. 111, no. 2, pp. 213-219. https://doi.org/10.1038/bjc.2014.311

APA

Kluth, L. A., Abdollah, F., Xylinas, E., Rieken, M., Fajkovic, H., Seitz, C., Sun, M., Karakiewicz, P. I., Schramek, P., Herman, M. P., Becker, A., Hansen, J., Ehdaie, B., Loidl, W., Pummer, K., Lee, R. K., Lotan, Y., Scherr, D. S., Seiler, D., ... Shariat, S. F. (2014). Clinical nodal staging scores for prostate cancer: a proposal for preoperative risk assessment. BRIT J CANCER, 111(2), 213-219. https://doi.org/10.1038/bjc.2014.311

Vancouver

Kluth LA, Abdollah F, Xylinas E, Rieken M, Fajkovic H, Seitz C et al. Clinical nodal staging scores for prostate cancer: a proposal for preoperative risk assessment. BRIT J CANCER. 2014 Jul 15;111(2):213-219. https://doi.org/10.1038/bjc.2014.311

Bibtex

@article{18af9800718b4e4aaec13768896dc936,
title = "Clinical nodal staging scores for prostate cancer: a proposal for preoperative risk assessment",
abstract = "BACKGROUND: Pelvic lymph node dissection in patients undergoing radical prostatectomy for clinically localised prostate cancer is not without morbidity and its therapeutical benefit is still a matter of debate. The objective of this study was to develop a model that allows preoperative determination of the minimum number of lymph nodes needed to be removed at radical prostatectomy to ensure true nodal status.METHODS: We analysed data from 4770 patients treated with radical prostatectomy and pelvic lymph node dissection between 2000 and 2011 from eight academic centres. For external validation of our model, we used data from a cohort of 3595 patients who underwent an anatomically defined extended pelvic lymph node dissection. We estimated the sensitivity of pathological nodal staging using a beta-binomial model and developed a novel clinical (preoperative) nodal staging score (cNSS), which represents the probability that a patient has lymph node metastasis as a function of the number of examined nodes.RESULTS: In the development and validation cohorts, the probability of missing a positive lymph node decreases with increase in the number of nodes examined. A 90% cNSS can be achieved in the development and validation cohorts by examining 1-6 nodes in cT1 and 6-8 nodes in cT2 tumours. With 11 nodes examined, patients in the development and validation cohorts achieved a cNSS of 90% and 80% with cT3 tumours, respectively.CONCLUSIONS: Pelvic lymph node dissection is the only reliable technique to ensure accurate nodal staging in patients treated with radical prostatectomy for clinically localised prostate cancer. The minimum number of examined lymph nodes needed for accurate nodal staging may be predictable, being strongly dependent on prostate cancer characteristics at diagnosis.",
keywords = "Aged, Aged, 80 and over, Cohort Studies, Humans, Lymph Node Excision, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging, Prostatectomy, Prostatic Neoplasms, Risk Assessment",
author = "Kluth, {L A} and F Abdollah and E Xylinas and M Rieken and H Fajkovic and C Seitz and M Sun and Karakiewicz, {P I} and P Schramek and Herman, {M P} and A Becker and J Hansen and B Ehdaie and W Loidl and K Pummer and Lee, {R K} and Y Lotan and Scherr, {D S} and D Seiler and Ahyai, {S A} and Chun, {F K-H} and M Graefen and A Tewari and A Nonis and A Bachmann and F Montorsi and M G{\"o}nen and A Briganti and Shariat, {S F}",
year = "2014",
month = jul,
day = "15",
doi = "10.1038/bjc.2014.311",
language = "English",
volume = "111",
pages = "213--219",
journal = "BRIT J CANCER",
issn = "0007-0920",
publisher = "NATURE PUBLISHING GROUP",
number = "2",

}

RIS

TY - JOUR

T1 - Clinical nodal staging scores for prostate cancer: a proposal for preoperative risk assessment

AU - Kluth, L A

AU - Abdollah, F

AU - Xylinas, E

AU - Rieken, M

AU - Fajkovic, H

AU - Seitz, C

AU - Sun, M

AU - Karakiewicz, P I

AU - Schramek, P

AU - Herman, M P

AU - Becker, A

AU - Hansen, J

AU - Ehdaie, B

AU - Loidl, W

AU - Pummer, K

AU - Lee, R K

AU - Lotan, Y

AU - Scherr, D S

AU - Seiler, D

AU - Ahyai, S A

AU - Chun, F K-H

AU - Graefen, M

AU - Tewari, A

AU - Nonis, A

AU - Bachmann, A

AU - Montorsi, F

AU - Gönen, M

AU - Briganti, A

AU - Shariat, S F

PY - 2014/7/15

Y1 - 2014/7/15

N2 - BACKGROUND: Pelvic lymph node dissection in patients undergoing radical prostatectomy for clinically localised prostate cancer is not without morbidity and its therapeutical benefit is still a matter of debate. The objective of this study was to develop a model that allows preoperative determination of the minimum number of lymph nodes needed to be removed at radical prostatectomy to ensure true nodal status.METHODS: We analysed data from 4770 patients treated with radical prostatectomy and pelvic lymph node dissection between 2000 and 2011 from eight academic centres. For external validation of our model, we used data from a cohort of 3595 patients who underwent an anatomically defined extended pelvic lymph node dissection. We estimated the sensitivity of pathological nodal staging using a beta-binomial model and developed a novel clinical (preoperative) nodal staging score (cNSS), which represents the probability that a patient has lymph node metastasis as a function of the number of examined nodes.RESULTS: In the development and validation cohorts, the probability of missing a positive lymph node decreases with increase in the number of nodes examined. A 90% cNSS can be achieved in the development and validation cohorts by examining 1-6 nodes in cT1 and 6-8 nodes in cT2 tumours. With 11 nodes examined, patients in the development and validation cohorts achieved a cNSS of 90% and 80% with cT3 tumours, respectively.CONCLUSIONS: Pelvic lymph node dissection is the only reliable technique to ensure accurate nodal staging in patients treated with radical prostatectomy for clinically localised prostate cancer. The minimum number of examined lymph nodes needed for accurate nodal staging may be predictable, being strongly dependent on prostate cancer characteristics at diagnosis.

AB - BACKGROUND: Pelvic lymph node dissection in patients undergoing radical prostatectomy for clinically localised prostate cancer is not without morbidity and its therapeutical benefit is still a matter of debate. The objective of this study was to develop a model that allows preoperative determination of the minimum number of lymph nodes needed to be removed at radical prostatectomy to ensure true nodal status.METHODS: We analysed data from 4770 patients treated with radical prostatectomy and pelvic lymph node dissection between 2000 and 2011 from eight academic centres. For external validation of our model, we used data from a cohort of 3595 patients who underwent an anatomically defined extended pelvic lymph node dissection. We estimated the sensitivity of pathological nodal staging using a beta-binomial model and developed a novel clinical (preoperative) nodal staging score (cNSS), which represents the probability that a patient has lymph node metastasis as a function of the number of examined nodes.RESULTS: In the development and validation cohorts, the probability of missing a positive lymph node decreases with increase in the number of nodes examined. A 90% cNSS can be achieved in the development and validation cohorts by examining 1-6 nodes in cT1 and 6-8 nodes in cT2 tumours. With 11 nodes examined, patients in the development and validation cohorts achieved a cNSS of 90% and 80% with cT3 tumours, respectively.CONCLUSIONS: Pelvic lymph node dissection is the only reliable technique to ensure accurate nodal staging in patients treated with radical prostatectomy for clinically localised prostate cancer. The minimum number of examined lymph nodes needed for accurate nodal staging may be predictable, being strongly dependent on prostate cancer characteristics at diagnosis.

KW - Aged

KW - Aged, 80 and over

KW - Cohort Studies

KW - Humans

KW - Lymph Node Excision

KW - Lymphatic Metastasis

KW - Male

KW - Middle Aged

KW - Neoplasm Staging

KW - Prostatectomy

KW - Prostatic Neoplasms

KW - Risk Assessment

U2 - 10.1038/bjc.2014.311

DO - 10.1038/bjc.2014.311

M3 - SCORING: Journal article

C2 - 25003663

VL - 111

SP - 213

EP - 219

JO - BRIT J CANCER

JF - BRIT J CANCER

SN - 0007-0920

IS - 2

ER -