Yonsei nomogram to predict lymph node invasion in Asian men with prostate c - Evidencio
Yonsei nomogram to predict lymph node invasion in Asian men with prostate cancer during robotic era
Current guidelines recommend performing pelvic lymph node dissection based on the estimated risk of lymph node invasion and several nomograms have been created to better predict this risk. However, the accuracy of these predictive models may be influenced by several factors. The characteristics of the study population are crucial in the performance of nomograms and ethnic differences in the behaviour of prostate cancer have been well documented.
Research authors: Kwang Hyun Kim, Sey Kiat Lim, Ha Yan Kim, Woong Kyu Han, Young Deuk Choi, Byung Ha Chung, Sung Joon Hong, Koon Ho Rha
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No general consensus has been reached on how to decide the optimal nomogram cut-off value to recommend pelvic lymph node dissection. Existing guidelines and nomograms suggest a cut-off value which allows ≈50% of patients to be spared pelvic lymph node dissection while minimising missing patients with lymph node invasion. 
With a cutoff value of 4%, pelvic lymph node dissection could be omitted in 326 patients (60.2%), missing only two patients (4.4%) with lymph node invasion. The sensitivity, specificity, positive predictive value and negative predictive value were 95.6%, 65.3%, 20.0% and 99.4%, respectively

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