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; p < 0.0001) and as a categorical variable (HR = 3.399; 95% CI: 1.740-6.638; p < 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.
Urologia. 2024 May 23 [Epub ahead of print]
Antonio Benito Porcaro, Sonia Costantino, Claudio Brancelli, Alberto Baielli, Francesco Artoni, Francesca Montanaro, Sebastian Gallina, Alberto Bianchi, Emanuele Serafin, Alessandro Veccia, Andrea Franceschini, Riccardo Rizzetto, Matteo Brunelli, Filippo Migliorini, Riccardo Giuseppe Bertolo, Maria Angela Cerruto, Alessandro Antonelli
Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy., Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.