Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
Urologia. 2024 Aug;91(3):531-537. doi: 10.1177/03915603241252911. Epub 2024 May 23.
To investigate the potential prognostic impact of Briganti's 2012 nomogram in EAU intermediate-risk patients presenting with an unfavorable tumor grade and treated with robot-assisted radical prostatectomy, eventually associated with extended pelvic lymph node dissection.
From January 2013 to December 2021, the study included 179 EAU intermediate-risk patients presenting with an unfavorable tumor grade (ISUP 3), eventually associated with a PSA of 10-20 ng/ml and/or cT-2b. Briganti's 2012 nomogram was assessed as both a continuous and dichotomous variable, categorized according to the median (risk score ⩾7% vs <7%). Disease progression, defined as biochemical recurrence and/or metastatic progression, was evaluated using Cox proportional hazards in both univariate and multivariate analyses.
Disease progression occurred in 43 (24%) patients after a median (95% CI) follow-up of 78 (65.7-88.4) months. The nomogram risk score predicted disease progression, evaluated both as a continuous variable (hazard ratio, HR = 1.064; 95% CI: 1.035-1.093; < 0.0001) and as a categorical variable (HR = 3.399; 95% CI: 1.740-6.638; < 0.0001). This association was confirmed in multivariate analysis, where hazard ratios remained consistent even after adjusting for clinical and pathological factors.
In EAU intermediate-risk PCa cases presenting with an unfavorable tumor grade and treated surgically, Briganti's 2012 nomogram was associated with disease progression after surgery. Consequently, as the nomogram risk score increased, patients were more likely to experience PCa progression, facilitating the stratification of the patient population into distinct prognostic subgroups.
为了研究 Briganti 2012 年列线图在具有不利肿瘤分级的 EAU 中危患者中的潜在预后影响，这些患者接受机器人辅助根治性前列腺切除术治疗，最终与扩大骨盆淋巴结清扫术相关。
从 2013 年 1 月至 2021 年 12 月，本研究纳入了 179 名具有不利肿瘤分级（ISUP3）的 EAU 中危患者，最终 PSA 为 10-20ng/ml 和/或 cT-2b。Briganti 2012 年列线图被评估为连续变量和二分类变量，根据中位数（风险评分 ⩾7%与 <7%）进行分类。使用 Cox 比例风险在单因素和多因素分析中评估疾病进展，定义为生化复发和/或转移进展。
在中位（95%CI：65.7-88.4）78 个月的随访后，43 名（24%）患者发生疾病进展。列线图风险评分预测疾病进展，评估为连续变量（危险比，HR=1.064；95%CI：1.035-1.093；<0.0001）和分类变量（HR=3.399；95%CI：1.740-6.638；<0.0001）。该关联在多因素分析中得到证实，即使在调整了临床和病理因素后，危险比仍然一致。
在具有不利肿瘤分级的 EAU 中危 PCa 患者中，手术治疗后 Briganti 2012 年列线图与术后疾病进展相关。因此，随着列线图风险评分的增加，患者更有可能发生 PCa 进展，有助于将患者人群分层为不同的预后亚组。
