Development and Validation of a Nomogram for the Prediction of Inguinal Lymph Node Metastasis Extranodal Extension in Penile Cancer

Wu, Chong1,2,3; Li, Zaishang4,5,6; Guo, Shengjie1,2,3; Zhou, Fangjian1,2,3; Han, Hui1,2,3

2021-06-17

10.3389/fonc.2021.675565

Frontiers in Oncology   影响因子和分区

2234-943X

Purpose To determine whether a clinicopathologic and laboratory-based nomogram is capable of predicting the risk of lymph node extranodal extension (ENE) in patients with penile cancer. Materials and Methods From June 2006 to January 2021, 234 patients who underwent bilateral inguinal lymph node dissection (ILND) surgery were included in the analysis. A Lasso regression model was utilized to select the most useful predictive features from among 46 laboratory variables. Then, a logistic regression analysis was used to develop the prediction model. Calibration curves, concordance index (C-index) and Areas under the receiver-operating characteristic curves (AUCs) were performed to evaluate the performance of the nomogram. We also investigated model fit using changes in Akaike Information Criteria (AICs). Decision curve analyses (DCAs) were applied to assess the clinical usefulness of this nomograms. Its internal validation was confirmed. Results Among the 234 patients, 53 were confirmed to have ENE. The platelet-lymphocyte ratio (PLR) and Squamous cell carcinoma antigen (SCC-Ag) were significantly associated with ENE (P<0.05). The individualized prediction nomogram, including the PLR, SCC-Ag, lymphovascular invasion (LVI), and pathologic tumor stage(pT-stage), showed good discrimination, with a C-index of 0.817 (95% CI, 0.745 to 0.890) and good calibration. Clinical-laboratory nomogram (AIC, 180.034) become the best-fitting model. DCA findings revealed that the clinical-laboratory nomogram was more clinically useful than the pT-stage or tumor grade. Conclusions This study presents a clinicopathologic and laboratory-based nomogram that incorporates PLR, SCC-Ag, lymphovascular invasion (LVI), and pT-stage, which can be conveniently utilized to facilitate the individualized prediction of lymph node metastasis ENE in patients with penile cancer.

risk assessment risk model nomogram extranodal extension penile cancer

SCI

英语

其他

National Natural Science Foundation of China[".81772755",81902610] ; Science and Technology Planning Project of Shenzhen Municipality (CN)[JCYJ20190807145409328]

Oncology

Oncology

WOS:000668623400001

FRONTIERS MEDIA SA

Web of Science

1.Sun Yat Sen Univ, Ctr Canc, Dept Urol, Guangzhou, Peoples R China
2.State Key Lab Oncol South China, Guangzhou, Peoples R China
3.Collaborat Innovat Ctr Canc Med, Guangzhou, Peoples R China
4.Jinan Univ, Clin Med Coll 2, Shenzhen Peoples Hosp, Dept Urol, Shenzhen, Peoples R China
5.Southern Univ Sci & Technol, Affiliated Hosp 1, Dept Urol, Shenzhen, Peoples R China
6.Minimally Invas Urol Shenzhen Res & Dev Ctr Med E, Shenzhen, Peoples R China

Wu, Chong,Li, Zaishang,Guo, Shengjie,et al. Development and Validation of a Nomogram for the Prediction of Inguinal Lymph Node Metastasis Extranodal Extension in Penile Cancer[J]. Frontiers in Oncology,2021,11.

Wu, Chong,Li, Zaishang,Guo, Shengjie,Zhou, Fangjian,&Han, Hui.(2021).Development and Validation of a Nomogram for the Prediction of Inguinal Lymph Node Metastasis Extranodal Extension in Penile Cancer.Frontiers in Oncology,11.

Wu, Chong,et al."Development and Validation of a Nomogram for the Prediction of Inguinal Lymph Node Metastasis Extranodal Extension in Penile Cancer".Frontiers in Oncology 11(2021).