PMID- 29249688
OWN - NLM
STAT- MEDLINE
DCOM- 20201009
LR  - 20221207
IS  - 2405-4569 (Electronic)
IS  - 2405-4569 (Linking)
VI  - 5
IP  - 3
DP  - 2019 May
TI  - A Head-to-head Comparison of Four Prognostic Models for Prediction of Lymph Node 
      Invasion in African American and Caucasian Individuals.
PG  - 449-456
LID - S2405-4569(17)30269-9 [pii]
LID - 10.1016/j.euf.2017.11.013 [doi]
AB  - BACKGROUND: Four nomograms are available for the prediction of lymph node 
      invasion (LNI) prior to radical prostatectomy (RP): the Cagiannos, the 
      2012-Briganti, the Godoy, and the online-Memorial Sloan Kettering Cancer Center 
      (MSKCC). None was tested in African Americans (AAs). OBJECTIVE: To perform a 
      validation and head-to-head comparison of four nomograms for the prediction of 
      LNI in AAs. DESIGN, SETTING, AND PARTICIPANTS: Within the Surveillance 
      Epidemiology and End Results database (2010-2014), we identified 14 077 
      Caucasians and 2668 AAs with clinically localised prostate cancer. INTERVENTION: 
      RP and pelvic lymph node dissection (PLND). OUTCOME MEASUREMENTS AND STATISTICAL 
      ANALYSIS: Predicted and observed LNI rates for the four nomograms were tested 
      between AAs and Caucasians with Heagerty's concordance index (C-index), 
      calibration plots, decision curve analyses (DCAs), and nomogram-derived cut-offs 
      for avoided PLND and missed LNI cases. RESULTS AND LIMITATIONS: All C-index 
      values were lower in AAs than in Caucasians: Cagiannos (76.1% vs 79.5%), Godoy 
      (73.0% vs 79.4%), 2012-Briganti (73.3% vs 81.3%), and MSKCC (72.6% vs 81.6%). All 
      four nomogram calibration plots showed invariably worse performances in AAs. In 
      DCAs focusing on AAs, the Cagiannos nomogram provided the highest net benefit 
      relative to the remaining three nomograms. In nomogram cut-off analyses testing 
      the number of avoided PLND against the number of missed LNI cases, the Cagiannos 
      nomogram yielded the best results when tested in AAs. However, in DCAs and 
      cut-off analyses that compared AAs with Caucasians, AAs yielded less favourable 
      outcomes regardless of which nomogram was tested. We lack a central pathology 
      review and standardisation of PLND templates. CONCLUSIONS: In AAs, the Cagiannos 
      nomogram provides the optimal results relative to the remaining three nomograms. 
      Nonetheless, all tested nomograms yielded worse metrics in AAs than in 
      Caucasians. PATIENT SUMMARY: All four tested nomograms can be equally considered 
      in Caucasians. Conversely, the Cagiannos nomogram should be preferred in African 
      Americans.
CI  - Copyright (c) 2017 European Association of Urology. Published by Elsevier B.V. All 
      rights reserved.
FAU - Bandini, Marco
AU  - Bandini M
AD  - Cancer Prognostics and Health Outcomes Unit, University of Montreal Health 
      Center, Montreal, Quebec, Canada; Division of Oncology/Unit of Urology, URI, 
      IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, 
      Milan, Italy. Electronic address: bandini.marco@hsr.it.
FAU - Marchioni, Michele
AU  - Marchioni M
AD  - Cancer Prognostics and Health Outcomes Unit, University of Montreal Health 
      Center, Montreal, Quebec, Canada; Department of Urology, SS Annunziata Hospital, 
      "G. D'Annunzio" University of Chieti, Chieti, Italy.
FAU - Preisser, Felix
AU  - Preisser F
AD  - Cancer Prognostics and Health Outcomes Unit, University of Montreal Health 
      Center, Montreal, Quebec, Canada; Martini Klinik, University Medical Center 
      Hamburg-Eppendorf, Hamburg, Germany.
FAU - Nazzani, Sebastiano
AU  - Nazzani S
AD  - Cancer Prognostics and Health Outcomes Unit, University of Montreal Health 
      Center, Montreal, Quebec, Canada; Academic Department of Urology, IRCCS 
      Policlinico San Donato, University of Milan, Milan, Italy.
FAU - Tian, Zhe
AU  - Tian Z
AD  - Cancer Prognostics and Health Outcomes Unit, University of Montreal Health 
      Center, Montreal, Quebec, Canada.
FAU - Fossati, Nicola
AU  - Fossati N
AD  - Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, 
      Italy; Vita-Salute San Raffaele University, Milan, Italy.
FAU - Gandaglia, Giorgio
AU  - Gandaglia G
AD  - Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, 
      Italy; Vita-Salute San Raffaele University, Milan, Italy.
FAU - Shariat, Shahrokh F
AU  - Shariat SF
AD  - Department of Urology, Medical University of Vienna, Vienna, Austria.
FAU - Montorsi, Francesco
AU  - Montorsi F
AD  - Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, 
      Italy; Vita-Salute San Raffaele University, Milan, Italy.
FAU - Saad, Fred
AU  - Saad F
AD  - Cancer Prognostics and Health Outcomes Unit, University of Montreal Health 
      Center, Montreal, Quebec, Canada.
FAU - Briganti, Alberto
AU  - Briganti A
AD  - Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, 
      Italy; Vita-Salute San Raffaele University, Milan, Italy.
FAU - Tilki, Derya
AU  - Tilki D
AD  - Martini Klinik, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
FAU - Karakiewicz, Pierre I
AU  - Karakiewicz PI
AD  - Cancer Prognostics and Health Outcomes Unit, University of Montreal Health 
      Center, Montreal, Quebec, Canada.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20171214
PL  - Netherlands
TA  - Eur Urol Focus
JT  - European urology focus
JID - 101665661
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
MH  - Black or African American/*statistics & numerical data
MH  - Aged
MH  - Humans
MH  - Lymph Nodes/pathology
MH  - Lymphatic Metastasis/diagnosis/*pathology
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Grading
MH  - Nomograms
MH  - Prognosis
MH  - Prostate-Specific Antigen/blood
MH  - Prostatectomy/*statistics & numerical data
MH  - Prostatic Neoplasms/diagnosis/ethnology/*pathology/surgery
MH  - SEER Program
MH  - White People/*statistics & numerical data
OTO - NOTNLM
OT  - African American
OT  - Caucasian
OT  - Lymph node invasion
OT  - Nomogram
OT  - Pelvic lymph node dissection
OT  - Prostate cancer
OT  - Racial disparities
OT  - Radical prostatectomy
EDAT- 2017/12/19 06:00
MHDA- 2020/10/10 06:00
CRDT- 2017/12/19 06:00
PHST- 2017/10/07 00:00 [received]
PHST- 2017/11/10 00:00 [revised]
PHST- 2017/11/28 00:00 [accepted]
PHST- 2017/12/19 06:00 [pubmed]
PHST- 2020/10/10 06:00 [medline]
PHST- 2017/12/19 06:00 [entrez]
AID - S2405-4569(17)30269-9 [pii]
AID - 10.1016/j.euf.2017.11.013 [doi]
PST - ppublish
SO  - Eur Urol Focus. 2019 May;5(3):449-456. doi: 10.1016/j.euf.2017.11.013. Epub 2017 
      Dec 14.