• Firas Abdollah, Cesare Cozzarini, Maxine Sun, Nazareno Suardi, Andrea Gallina, Niccolò Maria Passoni, Marco Bianchi, Manuela Tutolo, Nicola Fossati, Alessandro Nini, Paolo Dell'oglio, Andrea Salonia, Pierre Karakiewicz, Francesco Montorsi, and Alberto Briganti.
• Department of Urology, Vita Salute San Raffaele University, Milan, Italy.
• Radiother Oncol. 2013 Nov 1; 109 (2): 211-6.

Background And PurposeThe 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.Material And MethodsWe 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.ResultsOverall, 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.ConclusionsAll 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.Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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