External validation of the Briganti nomogram predicting lymph node invasion in patients with intermediate and high-risk prostate cancer diagnosed with magnetic resonance imaging-targeted and systematic biopsies: A European multicenter study
UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS
Authors: Diamand, Romain; Oderda, Marco; Albisinni, Simone; Fourcade, Alexandre; Fournier, Georges; Benamran, Daniel; Iselin, Christophe; Fiard, Gaelle; Descotes, Jean-Luc; Assenmacher, Gregoire; Svistakov, Ilyas; Peltier, Alexandre; Simone, Giuseppe; Di Cosmo, Giacomo; Roche, Jean-Baptiste; Bonnal, Jean-Louis; Van Damme, Julien; Rossi, Maxime; Mandron, Eric; Gontero, Paolo; Roumeguere, Thierry
Abstract
Objective: To validate a nomogram predicting lymph node invasion (LNI) in prostate cancer patients undergoing radical prostatectomy taking into consideration multiparametric-magnetic resonance imaging (mp-MRI) parameters and targeted biopsies in a western European cohort. Patients and Methods: A total of 473 men diagnosed by targeted biopsies, using software-based MRI-ultrasound image fusion system, and operated by radical prostatectomy with extended pelvic lymph node dissection across 11 Europeans centers between 2012 and 2019 were identified. Area under the curve of the receiver operator characteristic curve, calibration plot and decision curve analysis were used to evaluated the performance of the model. Results: Overall, 56 (11.8%) patients had LNI on final pathologic examination with a median (IQR) of 13 (9-18) resected nodes. Significant differences (all P < 0.05) were found between patients with and without LNI in terms of preoperative PSA, clinical stage at DRE and mp-MRI, maximum diameter of the index lesion, PI-RADS score, Grade Group on systematic and targeted biopsies, total number of dissected lymph nodes, final pathologic staging and Grade Group. External validation of the prediction model showed a good accuracy with an area under the curve calculated as 0.8 (CI 95% 0.75-0.86). Graphic analysis of calibration plot and decision curve analysis showed a slight underestimation for predictive probability for LNI between 3% and 22% and a high net benefit. A cut-off at 7% was associated with a risk of missing LNI in 2.6%, avoiding unnecessary surgeries in 55.9%. Conclusions: We report an external validation of the nomogram predicting LNI in patients treated with extended pelvic lymph node dissection in a western European cohort and a cut-off at 7% seems appropriate. (C) 2020 Elsevier Inc. All rights reserved.
Ecological risks of demersal fishing on deepwater chondrichthyan populations in the Southern Indian and South Pacific Oceans
ICES JOURNAL OF MARINE SCIENCE
Authors: Georgeson, L.; Rigby, C. L.; Emery, T. J.; Fuller, M.; Hartog, J.; Williams, A. J.; Hobday, A. J.; Duffy, C. A. J.; Simpfendorfer, C. A.; Okuda, T.; Stobutzki, I. C.; Nicol, S. J.
Abstract
Risks to deepwater chondrichthyans (sharks, rays, and chimaeras) from fishing are poorly understood, particularly in areas beyond national jurisdiction. We adapted productivity-susceptibility analysis (PSA) and sustainability assessment for fishing effects (SAFE) to assess the vulnerability of 173 deepwater chondrichthyans to various demersal fishing gears in the Southern Indian and South Pacific Oceans. Several species were categorized as being at high or extreme vulnerability, including some deepwater shark species in the Southern Indian Ocean that are reported to be commercially targeted. There was good concurrence between PSA and SAFE results for species categorized as being at high or extreme vulnerability by the SAFE, but as expected there was an overall greater number assessed to be as higher vulnerability using PSA due to its precautionary nature. Our results indicate probable misclassifications in the PSA relative vulnerability rankings, highlighting the value of applying more quantitative tools, such as SAFE, when adequate data are available. Our findings indicate that better catch, effort, and biological information are needed to inform the assessment and management of deepwater chondrichthyans. If targeted fishing of deepwater shark species continues in the Southern Indian Ocean, improved assessments and estimates of sustainable yields are urgently required to mitigate the risk of overexploitation.