External validation of the Briganti nomogram predicting lymph node invasion in patients with intermediate and high-risk prostate cancer diagnosed with magnetic resonance imaging-targeted and systematic biopsies: A European multicenter study

Diamand, Romain; Oderda, Marco; Albisinni, Simone; Fourcade, Alexandre; Fournier, Georges; Benamran, Daniel; Iselin, Christophe; Fiard, G.; Descotes, J; Assenmacher, G.; Svistakov, I.; Peltier, Alexandre; Simone, Giuseppe; Cosmo, G. Di; Roche, Jean; Bonnal, J. L.; Damme, J. Van; Rossi, Maxime; Mandron, E.; Roumeguère, Thierry

doi:10.1016/j.urolonc.2020.04.011

Cited by 12 publications

(11 citation statements)

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“…showed how the 2012 model outperformed the 2019 nomogram in terms of accuracy (AUC: 0.79 vs. 0.76, respectively) and net-benefit, although without a statistically significant difference (16). Diamand et al found the same AUC of 0.8 for both Briganti 2012 and 2019, but with a better net benefit for the 2019 model (15). On the other hand, Gandaglia et al in a multi-institutional validation cohort comparing the performance of Briganti 2019 nomogram with those of Briganti 2012, 2017 and Memorial Sloan Kettering Cancer Center models, found a higher AUC for Briganti 2019 (79 vs. 75 vs. 65 vs. 74%), a better calibration and the highest net-benefit (13).…”

Section: Resultsmentioning

confidence: 99%

“…In this context, the novel Briganti 2019 nomogram has been developed in order to include the clinical staging at mpMRI and the Gleason score (GS) at MRI-targeted biopsy, with the aim of exploiting the ability of this diagnostic technique to detect clinically significant (cs) PCa, and thus, better identifying those patients with a greater risk of LNI. Several external validation studies had investigated the accuracy of the Briganti 2019 nomogram, with an AUC ranging between 76 and 80% using a risk threshold of 7% (13)(14)(15)(16). However, few studies have directly compared the accuracy of Briganti 2012 and 2019 nomograms, and therefore, the potential added value of mpMRI in nodal staging.…”

Section: Introductionmentioning

confidence: 99%

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External Validation and Comparison of Two Nomograms Predicting the Probability of Lymph Node Involvement in Patients subjected to Robot-Assisted Radical Prostatectomy and Concomitant Lymph Node Dissection: A Single Tertiary Center Experience in the MRI-Era

et al. 2022

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IntroductionTo externally validate and directly compare the performance of the Briganti 2012 and Briganti 2019 nomograms as predictors of lymph node invasion (LNI) in a cohort of patients treated with robot-assisted radical prostatectomy (RARP) and extended pelvic lymph node dissection (ePLND).Materials and MethodsAfter the exclusion of patients with incomplete biopsy, imaging, or clinical data, 752 patients who underwent RARP and ePLND between December 2014 to August 2021 at our center, were included. Among these patients, 327 (43.5%) had undergone multi-parametric MRI (mpMRI) and mpMRI-targeted biopsy. The preoperative risk of LNI was calculated for all patients using the Briganti 2012 nomogram, while the Briganti 2019 nomogram was used only in patients who had performed mpMRI with the combination of targeted and systematic biopsy. The performances of Briganti 2012 and 2019 models were evaluated using the area under the receiver-operating characteristics curve analysis, calibrations plot, and decision curve analysis.ResultsA median of 13 (IQR 9–18) nodes per patient was removed, and 78 (10.4%) patients had LNI at final pathology. The area under the curves (AUCs) for Briganti 2012 and 2019 were 0.84 and 0.82, respectively. The calibration plots showed a good correlation between the predicted probabilities and the observed proportion of LNI for both models, with a slight tendency to underestimation. The decision curve analysis (DCA) of the two models was similar, with a slightly higher net benefit for Briganti 2012 nomogram. In patients receiving both systematic- and targeted-biopsy, the Briganti 2012 accuracy was 0.85, and no significant difference was found between the AUCs of 2012 and 2019 nomograms (p = 0.296). In the sub-cohort of 518 (68.9%) intermediate-risk PCa patients, the Briganti 2012 nomogram outperforms the 2019 model in terms of accuracy (0.82 vs. 0.77), calibration curve, and net benefit at DCA.ConclusionThe direct comparison of the two nomograms showed that the most updated nomogram, which included MRI and MRI-targeted biopsy data, was not significantly more accurate than the 2012 model in the prediction of LNI, suggesting a negligible role of mpMRI in the current population.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

External Validation and Comparison of Two Nomograms Predicting the Probability of Lymph Node Involvement in Patients subjected to Robot-Assisted Radical Prostatectomy and Concomitant Lymph Node Dissection: A Single Tertiary Center Experience in the MRI-Era

et al. 2022

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“…Software-based fusion biopsies are considered the standard of care since 2018 [ 17 ] but our set predated the recommendation. However, the benefit of the latest Briganti 2018 over Briganti 2017 and Briganti 2012 appears to be small [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Development of a Radiomic-Based Model Predicting Lymph Node Involvement in Prostate Cancer Patients

Bourbonne

Jaouen

Nguyen

et al. 2021

Cancers

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Significant advances in lymph node involvement (LNI) risk modeling in prostate cancer (PCa) have been achieved with the addition of visual interpretation of magnetic resonance imaging (MRI) data, but it is likely that quantitative analysis could further improve prediction models. In this study, we aimed to develop and internally validate a novel LNI risk prediction model based on radiomic features extracted from preoperative multimodal MRI. All patients who underwent a preoperative MRI and radical prostatectomy with extensive lymph node dissection were retrospectively included in a single institution. Patients were randomly divided into the training (60%) and testing (40%) sets. Radiomic features were extracted from the index tumor volumes, delineated on the apparent diffusion coefficient corrected map and the T2 sequences. A ComBat harmonization method was applied to account for inter-site heterogeneity. A prediction model was trained using a neural network approach (Multilayer Perceptron Network, SPSS v24.0©) combining clinical, radiomic and all features. It was then evaluated on the testing set and compared to the current available models using the Receiver Operative Characteristics and the C-Index. Two hundred and eighty patients were included, with a median age of 65.2 y (45.3–79.6), a mean PSA level of 9.5 ng/mL (1.04–63.0) and 79.6% of ISUP ≥ 2 tumors. LNI occurred in 51 patients (18.2%), with a median number of extracted nodes of 15 (10–19). In the testing set, with their respective cutoffs applied, the Partin, Roach, Yale, MSKCC, Briganti 2012 and 2017 models resulted in a C-Index of 0.71, 0.66, 0.55, 0.67, 0.65 and 0.73, respectively, while our proposed combined model resulted in a C-Index of 0.89 in the testing set. Radiomic features extracted from the preoperative MRI scans and combined with clinical features through a neural network seem to provide added predictive performance compared to state of the art models regarding LNI risk prediction in PCa.

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“…In our external validation, the AUC of the Briganti 2019 nomogram was the lowest compared with that of the other nomograms calculated under the same conditions. There are currently three reports of external validations of the Briganti 2019 nomogram [21][22][23], all of which are from Europe and include a common author. Table 3 shows the AUCs of the nomograms calculated with their cohorts.…”

Section: Discussionmentioning

confidence: 99%

External validation of the Briganti 2019 nomogram to identify candidates for extended pelvic lymph node dissection among patients with high-risk clinically localized prostate cancer

et al. 2021

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Background We aimed to establish an external validation of the Briganti 2019 nomogram in a Japanese cohort to preoperatively evaluate the probability of lymph node invasion in patients with high-risk, clinically localized prostate cancer. Methods The cohort consisted of 278 patients with prostate cancer diagnosed using magnetic resonance imaging-targeted biopsy who underwent radical prostatectomy and extended pelvic lymph node dissection from 2012 to 2020. Patients were rated using the Briganti 2019 nomogram, which evaluates the probability of lymph node invasion. We used the area under curve of the receiver operating characteristic analysis to quantify the accuracy of the nomogram. Results Nineteen (6.8%) patients had lymph node invasion. The median number of lymph nodes removed was 18. The area under the curve for the Briganti 2019 was 0.71. When the cutoff was set at 7%, 84 (30.2%) patients with extended pelvic lymph node dissection could be omitted, and only 1 (1.2%) patient with lymph node invasion would be missed. Sensitivity, specificity, and negative predictive values at the 7% cutoff were 94.7, 32.0, and 98.8%, respectively. Conclusion This external validation showed that the Briganti 2019 nomogram was accurate, although there may still be scope for individual adjustments.

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External validation of the Briganti nomogram predicting lymph node invasion in patients with intermediate and high-risk prostate cancer diagnosed with magnetic resonance imaging-targeted and systematic biopsies: A European multicenter study

Cited by 12 publications

References 28 publications

External Validation and Comparison of Two Nomograms Predicting the Probability of Lymph Node Involvement in Patients subjected to Robot-Assisted Radical Prostatectomy and Concomitant Lymph Node Dissection: A Single Tertiary Center Experience in the MRI-Era

External Validation and Comparison of Two Nomograms Predicting the Probability of Lymph Node Involvement in Patients subjected to Robot-Assisted Radical Prostatectomy and Concomitant Lymph Node Dissection: A Single Tertiary Center Experience in the MRI-Era

Development of a Radiomic-Based Model Predicting Lymph Node Involvement in Prostate Cancer Patients

External validation of the Briganti 2019 nomogram to identify candidates for extended pelvic lymph node dissection among patients with high-risk clinically localized prostate cancer

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