External Validation and Comparison of Briganti, Partin, and MSKCC Nomograms for Predicting Lymph Node Metastasis in a Large Turkish Radical Prostatectomy Cohort.

Abstract

Introduction: This study aimed to assess the predictive power of the "Briganti", "Partin" and "Memorial Sloan Kettering Cancer Center" (MSKCC) nomograms in the Turkish population.

Methods: Between 2010 and 2021, 575 patients retrospectively evaluated in our center who underwent radical prostatectomy and bilateral pelvic lymph node dissection. The patients' lymph node invasion risk was calculated from every three nomograms and compared with the lymph node invasion rates. The general accuracy of the nomograms in predicting metastatic lymph node disease was measured by creating the characteristic ROC curve.

Results: The average age of patients were 63,9 ± 6,7 (40-79) and lymph node involvement was present in 8.6% of all patients. Considering the 5% cut-off value according to the European Association of Urology guideline and 2% cut-off value based on National Comprehensive Cancer Network's guideline, the accuracies of the nomograms were 76.8% (95% Confidence Interval [CI]: 0.700-0.836, p<0.001) and 68.2% (95% CI: 0.623-0.742, p<0.001) for the Briganti nomogram; and 74.2% (95% CI: 0.684-0.818, p<0.001) and 77.6% (95% CI: 0.710-0.841, p<0.001) for the Partin nomogram, respectively. For the MSKCC nomogram, it was determined to be 75.1% (95% CI: 0.684-0.816, p<0.001) and 69.6% (95% CI: 0.638-0.754, p<0.001).

Conclusion: All three nomograms demonstrated clinically relevant predictive accuracy in predicting lymph node metastasis. In particular, the Partin nomogram revealed the highest predictive power according to the NCCN criteria. These findings provide evidence for external validity of these nomograms for clinical use in the Turkish population.