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Open Access 02-09-2021 | Prostate Cancer | Original Article

On the probability of lymph node negativity in pN0-staged prostate cancer—a theoretically derived rule of thumb for adjuvant needs

Authors: Dr. Frank Paulsen, Jens Bedke, Daniel Wegener, Jolanta Marzec, Peter Martus, Dominik Nann, Arnulf Stenzl, Daniel Zips, Arndt-Christian Müller

Published in: Strahlentherapie und Onkologie | Issue 8/2022

Abstract

Purpose

The extent of lymphadenectomy and clinical features influence the risk of occult nodes in node-negative prostate cancer. We derived a simple estimation model for the negative predictive value (npv) of histopathologically node-negative prostate cancer patients (pN0) to guide adjuvant treatment.

Methods

Approximations of sensitivities in detecting lymph node metastasis from current publications depending on the number of removed lymph nodes were used for a theoretical deduction of a simplified formulation of npv assuming a false node positivity of 0.

Results

A theoretical formula of npv = p(N0IpN0) = (100 − prevalence) / (100 − sensitivity × prevalence) was calculated (sensitivity and preoperative prevalence in %). Depending on the number of removed lymph nodes (nLN), the sensitivity of pN0-staged prostate cancer was derived for three sensitivity levels accordingly: sensitivity = f(nLN) = 9 × nLN /100 for 0 ≤ nLN ≤ 8 and f(nLN) = (nLN + 70) /100 for 9 ≤ nLN ≤ 29 and f(nLN) = 1 for nLN ≥ 30.

Conclusion

We developed a theoretical formula for estimation of the npv in pN0-staged prostate cancer patients. It is a sine qua non to use the formula in a clinically experienced context before deciding to electively irradiate pelvic lymph nodes or to intensify adjuvant systemic treatment.

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Title: On the probability of lymph node negativity in pN0-staged prostate cancer—a theoretically derived rule of thumb for adjuvant needs
Authors: Dr. Frank Paulsen
Jens Bedke
Daniel Wegener
Jolanta Marzec
Peter Martus
Dominik Nann
Arnulf Stenzl
Daniel Zips
Arndt-Christian Müller
Publication date: 02-09-2021
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Metastasis
Prostate Cancer
Radiotherapy
Lymphadenectomy
Published in: Strahlentherapie und Onkologie / Issue 8/2022
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-021-01841-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

On the probability of lymph node negativity in pN0-staged prostate cancer—a theoretically derived rule of thumb for adjuvant needs

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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