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External Validation of Models for Prediction of Lymph Node Metastasis in Urothelial Carcinoma of the Bladder.

Ku JH, Kim M, Byun SS, Jeong H, Kwak C, Kim HH, Lee SE - PLoS ONE (2015)

Bottom Line: The overall predictive values of models were compared with the criteria of overall performance, discrimination, calibration, and clinical usefulness.On decision curve analysis, pNSS performed better than other models across a wide range of threshold probabilities.The findings suggest that the application of pNSS to Asian patients is feasible.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Seoul National University Hospital, Seoul, Korea.

ABSTRACT

Purpose: To externally validate models to predict LN metastsis; Karakiewicz nomogram, clinical nodal staging score (cNSS), and pathologic nodal staging score (pNSS) using a different cohort.

Materials and methods: Clinicopathologic data from 500 patients who underwent radical cystectomy and pelvic lymphadenectomy were analyzed. The overall predictive values of models were compared with the criteria of overall performance, discrimination, calibration, and clinical usefulness.

Results: Presence of pN+ stages was recorded in 117 patients (23.4%). Agreement between clinical and pathologic stage was noted in 174 (34.8%). Based on Nagelkerke's peudo-R2 and brier score, pNSS demonstrated best overall performance. Area under the receiver operating characteristics curve, showed that pNSS had the best discriminatory ability. In all models, calibration was on average correct (calibration-in-the-large coefficient = zero). On decision curve analysis, pNSS performed better than other models across a wide range of threshold probabilities.

Conclusions: When compared to pNSS, current precystectomy models such as the Karakiewicz nomogram and cNSS cannot predict the probability of LN metastases accurately. The findings suggest that the application of pNSS to Asian patients is feasible.

No MeSH data available.


Related in: MedlinePlus

Calibration plots.(A) Number of lymph nodes removed. (B) Karakiewicz nomogram. (C) Clinical nodal staging score. (D) Pathologic nodal staging score.
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pone.0120552.g001: Calibration plots.(A) Number of lymph nodes removed. (B) Karakiewicz nomogram. (C) Clinical nodal staging score. (D) Pathologic nodal staging score.

Mentions: In all models, calibration was on average correct (calibration-in-the-large coefficient = zero), and the effects of predictors were also on average correct in the new setting (calibration slope = 1) (Table 3). However, the calibration plots in Fig 1 demonstrated an underestimation of LN metastases. Even the calibration curve of pNSS did not perfectly match the line of identity (the line at a 45° angle) although the deviation was pictorially minimal.


External Validation of Models for Prediction of Lymph Node Metastasis in Urothelial Carcinoma of the Bladder.

Ku JH, Kim M, Byun SS, Jeong H, Kwak C, Kim HH, Lee SE - PLoS ONE (2015)

Calibration plots.(A) Number of lymph nodes removed. (B) Karakiewicz nomogram. (C) Clinical nodal staging score. (D) Pathologic nodal staging score.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4591286&req=5

pone.0120552.g001: Calibration plots.(A) Number of lymph nodes removed. (B) Karakiewicz nomogram. (C) Clinical nodal staging score. (D) Pathologic nodal staging score.
Mentions: In all models, calibration was on average correct (calibration-in-the-large coefficient = zero), and the effects of predictors were also on average correct in the new setting (calibration slope = 1) (Table 3). However, the calibration plots in Fig 1 demonstrated an underestimation of LN metastases. Even the calibration curve of pNSS did not perfectly match the line of identity (the line at a 45° angle) although the deviation was pictorially minimal.

Bottom Line: The overall predictive values of models were compared with the criteria of overall performance, discrimination, calibration, and clinical usefulness.On decision curve analysis, pNSS performed better than other models across a wide range of threshold probabilities.The findings suggest that the application of pNSS to Asian patients is feasible.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Seoul National University Hospital, Seoul, Korea.

ABSTRACT

Purpose: To externally validate models to predict LN metastsis; Karakiewicz nomogram, clinical nodal staging score (cNSS), and pathologic nodal staging score (pNSS) using a different cohort.

Materials and methods: Clinicopathologic data from 500 patients who underwent radical cystectomy and pelvic lymphadenectomy were analyzed. The overall predictive values of models were compared with the criteria of overall performance, discrimination, calibration, and clinical usefulness.

Results: Presence of pN+ stages was recorded in 117 patients (23.4%). Agreement between clinical and pathologic stage was noted in 174 (34.8%). Based on Nagelkerke's peudo-R2 and brier score, pNSS demonstrated best overall performance. Area under the receiver operating characteristics curve, showed that pNSS had the best discriminatory ability. In all models, calibration was on average correct (calibration-in-the-large coefficient = zero). On decision curve analysis, pNSS performed better than other models across a wide range of threshold probabilities.

Conclusions: When compared to pNSS, current precystectomy models such as the Karakiewicz nomogram and cNSS cannot predict the probability of LN metastases accurately. The findings suggest that the application of pNSS to Asian patients is feasible.

No MeSH data available.


Related in: MedlinePlus