Briganti et al reported a nomogram for predicting pelvic lymph node metastases for a patient with prostate cancer. This is an update to the nomogram of Heidenreich et al. The authors are from Vita-Salute University in Milan and University of Montreal Health Centre.
Patient selection: prostate cancer
Parameters:
(1) PSA in ng/mL from 0 to 50
(2) clinical stage
(3) primary Gleason grade
(4) secondary Gleason grade
(5) percentage of positive cores (number of positive cores over the total number of cores taken)
points for PSA =
= 1.34 * (serum PSA)
points for percentage of positive cores =
= (percentage)
Parameter
Finding
Points
clinical stage
T1
0
T2
21.8
T3
74
primary Gleason grade
1 to 3
0
4 or 5
47.5
secondary Gleason grade
1 to 3
0
4 or 5
14.1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 302.6
• The higher the score the greater the risk of lymph node metastases.
Score
Percent with Lymph Node Involvement
< 63.7
< 2.5%
>= 63.7
X = (0.026981 * (score)) - 5.3541
probability = 1/(1 + EXP((-1) *X))
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