A novel predictive model for pelvic lymph node metastasis in patients with penile cancer: A multi-institutional study
A novel predictive model for pelvic lymph node metastasis in patients with penile cancer: A multi-institutional study
复制标题
阴茎癌患者盆腔淋巴结转移的新型预测模型：一项多机构研究
DOI：
10.1016/j.urolonc.2021.01.005
复制
发表时间：
2021-06-10
影响因子：
2.7
通讯作者：
Zhou, Fangjian
中科院分区：
文献类型：
--
作者：
Li, Zaishang;Han, Hui;Zhou, Fangjian
目的：我们确定临床病理形态图是否能够预测阴茎癌患者在腹股沟淋巴结清扫（ILND）后盆腔淋巴结转移（LNM）的风险。方法：回顾性分析在10个中心行盆腔淋巴结切除术的98例双侧ILND患者。采用逐步逻辑回归的方法，选取拟合图中最具预测性的特征，再采用多元逻辑回归分析进行检验和验证。采用一致性指数和校准曲线对模态图进行评估。结果：181例盆腔盆中，52例（43例）出现盆腔LNM。9例患者出现双侧盆腔LNM（9/43, 20.9%）。没有从一侧腹股沟转移到另一侧骨盆的交叉转移。多因素logistic回归分析显示，年龄、既往切除、腹股沟淋巴结活检方式、血管浸润、同侧腹股沟淋巴结状态均为盆腔淋巴结转移的独立危险因素（均P < 0.05）。nomogram显示了良好的生存一致性概率，一致性指数为0.868 （95% CI: 0.813-0.922）。结论：一种新的形态图提示骨盆LNM的风险可以有效地预测阴茎癌患者，并可能为临床医生提供有用的指导。需要进一步的外部验证。(C) 2021爱思唯尔公司版权所有。
Purpose: We determined whether a clinicopathological nomogram is able to predict the risk of pelvic lymph node metastasis (LNM) in penile cancer patients after inguinal lymph node dissection (ILND).Methods: Ninety-eight patients with bilateral ILND who underwent pelvic lymphadenectomy at 10 centers were retrospectively analyzed. The most predictive features in the nomogram were selected by the stepwise logistic regression method and then tested and verified by multivariate logistic regression analyses. The nomogram was assessed using concordance indices and calibration curves.Results: Of the 181 pelvic basins, pelvic LNM was observed in 52 packages (43 patients). Bilateral pelvic LNM was present in 9 patients (9/43, 20.9%). There was no crossover metastatic spread from one inguinal side to the other pelvic side. Age, previous resection, the biopsy procedure for inguinal lymph nodes, vascular invasion, and ipsilateral inguinal lymph node status were all independent risk factors for pelvic LNM (all P < 0.05) in the multivariate logistic regression analysis. The nomogram exhibited a good probability for survival agreement, with a concordance index of 0.868 (95% CI: 0.813-0.922).Conclusions: A novel nomogram suggests that the risk of pelvic LNM can be effectively predicted in penile carcinoma patients and may provide a useful guide for clinicians. Further external validation is needed. (C) 2021 Elsevier Inc. All rights reserved.