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The Briganti Nomogram is intended to support clinical decision making by estimating the risk that an extended Pelvic Lymph Node Dissection (ePLND) and biopsy would identify positive for a tumor in patients with clinically localized prostate cancer (PCa).
This version entails the Briganti 2023 Nomogram.
The Briganti 2023 Nomogram is applicable exclusively to patients with clinically localized prostate cancer and a negative preoperative prostate-specific membrane antigen positron emission tomography (miN0). Otherwise, alternative versions such as the Briganti 2012 Nomogram, Briganti 2017 Nomogram, or Briganti 2019 Nomogram should be employed.
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Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.
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The derivation cohort consisted of 485 patients with miN0M0 disease undergoing radical prostectomy (RP) and ePLND at 12 centers between 2017 and 2022. Overall 53 patients had lymph node involvement. Centers from the following countries were included: Austria, Belgium, China, Germany, Italy, the Netherlands, Spain, and Switzerland. Patients with cN1 or cM1 disease on abdominal CT or bone scans and those who received neoadjuvant therapies were excluded.
| Name | LL | Q1 | Median | Q3 | UL | Unit |
|---|---|---|---|---|---|---|
| Age at surgery (pN0 patients) | 62 | 68 | 72 | yr | ||
| Age at surgery (pN1 patients) | 63 | 68 | 72 | years | ||
| Initial PSA (pN0 patients) | 6 | 9 | 16 | ng/ml | ||
| Initial PSA (pN1 patients) | 6 | 11 | 20 | ng/ml | ||
| Prostate volume (pN0 patients) | 28 | 37 | 48 | ml | ||
| Prostate volume (pN1 patients) | 30 | 37 | 49 | ml | ||
| Number of PI-RADS ≥3 lesions at mpMRI | 1 | 1 | 2 | lesions | ||
| Dmax of the index lesion at mpMRI (pN0 patients) | 11 | 15 | 21 | mm | ||
| Dmax of the index lesion at mpMRI (pN1 patients) | 16 | 22 | 29 | mm | ||
| Cores taken (pN0 patients) | 12 | 14 | 16 | cores | ||
| Cores taken (pN1 patients) | 9 | 12 | 15 | cores | ||
| Positive cores (pN0 patients) | 4 | 6 | 9 | cores | ||
| Positive cores (pN1 patients) | 6 | 7 | 10 | cores | ||
| Percentage of positive cores (pN0 patients) | 29 | 50 | 64 | % | ||
| Percentage of positive cores (pN1 patients) | 50 | 67 | 83 | % | ||
| Positive cores with highest-grade PCa (pN0 patients) | 12 | 21 | 39 | % | ||
| Positive cores with highest-grade PCa (pN1 patients) | 21 | 42 | 60 | % | ||
| Positive cores with lower-grade PCa (pN0 patients) | 0 | 11 | 29 | % | ||
| Positive cores with lower-grade PCa (pN1 patients) | 0 | 7 | 23 | % | ||
| Target cores taken (pN0 patients) | 2 | 4 | 5 | cores | ||
| Target cores taken (pN1 patients) | 3 | 4 | 5 | cores | ||
| Positive cores at TBx (pN0 patients) | 1 | 3 | 4 | cores | ||
| Positive cores at TBx (pN1 patients) | 2 | 3 | 4 | cores | ||
| SBx cores taken (pN0 patients) | 10 | 12 | 12 | cores | ||
| SBx cores taken (pN1 patients) | 8 | 12 | 12 | cores | ||
| Cores with csPCa at SBx (pN0 patients) | 20 | 40 | 58 | % | ||
| Cores with csPCa at SBx (pN1 patients) | 42 | 58 | 78 | % | ||
| SUVmax (pN0 patients) | 7 | 12 | 22 | - | ||
| SUVmax (pN1 patients) | 8 | 14 | 22 | - | ||
| Lymph nodes removed (pN0 patients) | 10 | 15 | 22 | nodes | ||
| Lymph nodes removed (pN1 patients) | 14 | 18 | 26 | nodes | ||
| positive lymph nodes | 1 | 1 | 1 | nodes |
| Name | Subset / Group | Nr. of patients |
|---|---|---|
| Lymph node involvement | pN0 | 405 |
| Lymph node involvement | pN1 | 53 |
| Clinical stage (pN0 patients | cT1 | 160 |
| Clinical stage (pN0 patients | cT2 | 186 |
| Clinical stage (pN0 patients | cT3 | 16 |
| Clinical stage (pN1 patients) | cT1 | 12 |
| Clinical stage (pN1 patients) | cT2 | 23 |
| Clinical stage (pN1 patients) | cT3 | 9 |
| PI-RADS score (pN0 patients) | PI-RADS 3 | 30 |
| PI-RADS score (pN0 patients) | PI-RADS 4 | 163 |
| PI-RADS score (pN0 patients) | PI-RADS 5 | 212 |
| PI-RADS score (pN1 patients) | PI-RADS 3 | 2 |
| PI-RADS score (pN1 patients) | PI-RADS 4 | 8 |
| PI-RADS score (pN1 patients) | PI-RADS 5 | 43 |
| Clinical stage on mpMRI (pN0 patients) | Organ-confined | 284 |
| Clinical stage on mpMRI (pN0 patients) | Extracapsular extension | 83 |
| Clinical stage on mpMRI (pN0 patients) | Seminal vesicle invasion | 36 |
| Clinical stage on mpMRI (pN1 patients) | Organ-confined | 19 |
| Clinical stage on mpMRI (pN1 patients) | Extracapsular extension | 14 |
| Clinical stage on mpMRI (pN1 patients) | Seminal vesicle invasion | 19 |
| Biopsy grade group (pN0 patients) | Grade group 1 | 17 |
| Biopsy grade group (pN0 patients) | Grade group 2 | 53 |
| Biopsy grade group (pN0 patients) | Grade group 3 | 102 |
| Biopsy grade group (pN0 patients) | Grade group 4 | 162 |
| Biopsy grade group (pN0 patients) | Grade group 5 | 71 |
| Biopsy grade group (pN1 patients) | Grade group 1 | 1 |
| Biopsy grade group (pN1 patients) | Grade group 2 | 5 |
| Biopsy grade group (pN1 patients) | Grade group 3 | 14 |
| Biopsy grade group (pN1 patients) | Grade group 4 | 13 |
| Biopsy grade group (pN1 patients) | Grade group 5 | 20 |
| Grade group at TBx (pN0 patients) | Negative | 5 |
| Grade group at TBx (pN0 patients) | Grade group 1 | 17 |
| Grade group at TBx (pN0 patients) | Grade group 2 | 55 |
| Grade group at TBx (pN0 patients) | Grade group 3 | 85 |
| Grade group at TBx (pN0 patients) | Grade group 4 | 110 |
| Grade group at TBx (pN0 patients) | Grade group 5 | 39 |
| Grade group at TBx (pN1 patients) | Negative | 0 |
| Grade group at TBx (pN1 patients) | Grade group 1 | 1 |
| Grade group at TBx (pN1 patients) | Grade group 2 | 6 |
| Grade group at TBx (pN1 patients) | Grade group 3 | 5 |
| Grade group at TBx (pN1 patients) | Grade group 4 | 6 |
| Grade group at TBx (pN1 patients) | Grade group 5 | 13 |
| Grade group at SBx (pN0 patients) | Negative | 19 |
| Grade group at SBx (pN0 patients) | Grade group 1 | 29 |
| Grade group at SBx (pN0 patients) | Grade group 2 | 59 |
| Grade group at SBx (pN0 patients) | Grade group 3 | 86 |
| Grade group at SBx (pN0 patients) | Grade group 4 | 130 |
| Grade group at SBx (pN0 patients) | Grade group 5 | 49 |
| Grade group at SBx (pN1 patients) | Negative | 1 |
| Grade group at SBx (pN1 patients) | Grade group 1 | 1 |
| Grade group at SBx (pN1 patients) | Grade group 2 | 4 |
| Grade group at SBx (pN1 patients) | Grade group 3 | 9 |
| Grade group at SBx (pN1 patients) | Grade group 4 | 9 |
| Grade group at SBx (pN1 patients) | Grade group 5 | 13 |
| Surgical technique | Open radical | 22 |
| Surgical technique | Laparascopic radical | 8 |
| Surgical technique | Robot-assisted | 428 |
| Gleason grade group at final pathology (pN0 patients) | Grade group 1 | 10 |
| Gleason grade group at final pathology (pN0 patients) | Grade group 2 | 117 |
| Gleason grade group at final pathology (pN0 patients) | Grade group 3 | 126 |
| Gleason grade group at final pathology (pN0 patients) | Grade group 4 | 80 |
| Gleason grade group at final pathology (pN0 patients) | Grade group 5 | 71 |
| Gleason grade group at final pathology (pN1 patients) | Grade group 1 | 1 |
| Gleason grade group at final pathology (pN1 patients) | Grade group 2 | 4 |
| Gleason grade group at final pathology (pN1 patients) | Grade group 3 | 11 |
| Gleason grade group at final pathology (pN1 patients) | Grade group 4 | 7 |
| Gleason grade group at final pathology (pN1 patients) | Grade group 5 | 21 |
| Pathologic stage (pN0 patients) | pT2 | 158 |
| Pathologic stage (pN0 patients) | pT3a | 184 |
| Pathologic stage (pN0 patients) | pT3b/4 | 63 |
| Pathologic stage (pN1 patients) | pT2 | 3 |
| Pathologic stage (pN1 patients) | pT3a | 17 |
| Pathologic stage (pN1 patients) | pT3b/4 | 33 |
| Positive surgical margins | pN0 patients | 130 |
| Positive surgical margins | pN1 patients | 30 |
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Medical device In vitro diagnostic medical device |
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