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@ARTICLE{Gandaglia:298421,
      author       = {G. Gandaglia and F. Barletta and S. Scuderi and P.
                      Scilipoti and P. Rajwa and N. A. Huebner and J. Gomez Rivas
                      and L. Ibanez and T. F. W. Soeterik and L. Bianchi and A.
                      Mattei and C. Kesch$^*$ and C. Darr$^*$ and H. Guo and J.
                      Zhuang and F. Zattoni and W. P. Fendler and G. Marra and A.
                      Stabile and D. Robesti and D. Amparore and S. Joniau and R.
                      Schiavina and J. M. Sierra and F. Porpiglia and M. Picchio
                      and A. Chiti and A. Mottrie and R. C. N. van den Bergh and
                      S. F. Shariat and F. Montorsi and A. Briganti},
      title        = {{E}xternal {V}alidation of {N}omograms for the
                      {I}dentification of {P}elvic {N}odal {D}issection
                      {C}andidates {A}mong {P}rostate {C}ancer {P}atients with
                      {N}egative {P}reoperative {P}rostate-specific {M}embrane
                      {A}ntigen {P}ositron {E}mission {T}omography.},
      journal      = {European urology oncology},
      volume       = {nn},
      issn         = {2588-9311},
      address      = {Amsterdam},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2025-00277},
      pages        = {nn},
      year         = {2025},
      note         = {epub},
      abstract     = {Extended pelvic lymph node dissection (ePLND) is
                      recommended in selected radical prostatectomy (RP) prostate
                      cancer (PCa) patients for staging purposes. We aim to
                      externally validate available tools to predict lymph node
                      invasion (LNI) in men with negative preoperative
                      prostate-specific membrane antigen positron emission
                      tomography (miN0).Overall, 282 intermediate- to high-risk
                      PCa patients with miN0 disease undergoing RP and ePLND at
                      ten centers between 2016 and 2023 were identified. The
                      Memorial Sloan Kettering Cancer Center (MSKCC);
                      Amsterdam-Brisbane-Sydney; and Briganti 2017, 2019, and 2023
                      tools predicting LNI were validated externally using
                      calibration plots, C-indexes, and decision-curve analyses to
                      assess calibration, discrimination, and net benefit.Overall,
                      36 $(13\%)$ patients had LNI. The C-indexes of the MSKCC,
                      Briganti 2017, Briganti 2019, Amsterdam-Brisbane-Sydney, and
                      Briganti 2023 nomograms were $64\%,$ $69\%,$ $72\%,$ $64\%,$
                      and $77\%,$ respectively. The Briganti 2023 nomogram
                      exhibited higher net benefit than the other available
                      nomograms, and the use of a $5\%$ cutoff would have spared
                      $47\%$ ePLND procedures (vs $14\%$ and $4.3\%$ for the
                      Briganti 2019 and Amsterdam-Brisbane-Sydney nomograms,
                      respectively) at the cost of missing only five $(3.8\%)$ LNI
                      cases. Heterogeneity in patient selection and imaging
                      protocols represents the main limitations.The Briganti 2023
                      nomogram outperformed other available tools in predicting
                      LNI in men with miN0 PCa. The use of this tool resulted in a
                      considerable number of unnecessary ePLND procedures spared
                      and optimization of ePLND recommendations in a contemporary
                      clinical setting.},
      keywords     = {Lymph node invasion (Other) / Magnetic resonance
                      imaging–targeted biopsy (Other) / Nomogram (Other) /
                      Pelvic lymph node dissection (Other) / Prostate cancer
                      (Other) / Prostate-specific membrane antigen positron
                      emission tomography (Other) / Radical prostatectomy (Other)},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39890547},
      doi          = {10.1016/j.euo.2025.01.004},
      url          = {https://inrepo02.dkfz.de/record/298421},
}