Department of Urology, Vita Salute San Raffaele University, Milan, Italy.
Radiother Oncol. 2013 Nov;109(2):211-6. doi: 10.1016/j.radonc.2013.05.029. Epub 2013 Jun 30.
The aim of this study was to perform a head-to-head comparison of the Roach formula vs. two other newly developed prediction tools for lymph node invasion (LNI) in prostate cancer, namely the Nguyen and the Yu formulas.
We included 3115 patients treated with radical prostatectomy and extended pelvic lymph node dissection (ePLND), between 2000 and 2010 at a single center. The predictive accuracy of the three formulas was assessed and compared using the area-under-curve (AUC) and calibration methods. Moreover, decision curve analysis compared the net-benefit of the three formulas in a head-to-head fashion.
Overall, 10.8% of patients had LNI. The LNI-predicted risk was >15% in 25.5%, 3.4%, and 10.2% of patients according to the Roach, Nguyen and Yu formula, respectively. The AUC was 80.5%, 80.5% and 79%, respectively (all p>0.05). However, the Roach formula demonstrated more favorable calibration and generated the highest net-benefit relative to the other examined formulas in decision curve analysis.
All formulas demonstrated high and comparable discrimination accuracy in predicting LNI, when externally validated on ePLND treated patients. However, the Roach formula showed the most favorable characteristics. Therefore, its use should be preferred over the two other tools.
本研究旨在对头对头比较罗奇公式与另外两种新开发的用于预测前列腺癌淋巴结侵犯（LNI）的预测工具，即阮氏公式和于氏公式。
我们纳入了 2000 年至 2010 年间在单中心接受根治性前列腺切除术和扩大盆腔淋巴结清扫术（ePLND）治疗的 3115 例患者。使用曲线下面积（AUC）和校准方法评估并比较了这三种公式的预测准确性。此外，决策曲线分析以头对头的方式比较了三种公式的净收益。
总体而言，10.8%的患者存在 LNI。根据罗奇公式、阮氏公式和于氏公式，分别有 25.5%、3.4%和 10.2%的患者 LNI 预测风险>15%。AUC 分别为 80.5%、80.5%和 79%（均 P>0.05）。然而，罗奇公式在校准方面表现更优，在决策曲线分析中相对于其他检查公式产生了更高的净收益。
在对接受 ePLND 治疗的患者进行外部验证时，所有公式在预测 LNI 方面均表现出较高且相当的判别准确性。然而，罗奇公式表现出了最有利的特征。因此，应该优先使用该公式而不是其他两种工具。
