On the probability of lymph node negativity in pN0-staged prostate cancer-a theoretically derived rule of thumb for adjuvant needs.
Strahlenther Onkol
; 198(8): 690-699, 2022 08.
Article
em En
| MEDLINE
| ID: mdl-34476527
PURPOSE: The extent of lymphadenectomy and clinical features influence the risk of occult nodes in node-negative prostate cancer. We derived a simple estimation model for the negative predictive value (npv) of histopathologically node-negative prostate cancer patients (pN0) to guide adjuvant treatment. METHODS: Approximations of sensitivities in detecting lymph node metastasis from current publications depending on the number of removed lymph nodes were used for a theoretical deduction of a simplified formulation of npv assuming a false node positivity of 0. RESULTS: A theoretical formula of npvâ¯= p(N0IpN0)â¯= (100â¯- prevalence)â¯/â¯(100â¯- sensitivityâ¯× prevalence) was calculated (sensitivity and preoperative prevalence in %). Depending on the number of removed lymph nodes (nLN), the sensitivity of pN0-staged prostate cancer was derived for three sensitivity levels accordingly: sensitivityâ¯= f(nLN)â¯= 9â¯× nLN /100 for 0â¯≤ nLNâ¯≤ 8 and f(nLN)â¯= (nLNâ¯+ 70) /100 for 9â¯≤ nLNâ¯≤ 29 and f(nLN)â¯= 1 for nLNâ¯≥ 30. CONCLUSION: We developed a theoretical formula for estimation of the npv in pN0-staged prostate cancer patients. It is a sine qua non to use the formula in a clinically experienced context before deciding to electively irradiate pelvic lymph nodes or to intensify adjuvant systemic treatment.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Próstata
/
Heurística
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
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Male
Idioma:
En
Revista:
Strahlenther Onkol
Ano de publicação:
2022
Tipo de documento:
Article