ArticleInternational braz j urol : official journal of the Brazilian Society of Urology
Multicentre Validation of the 2019 Briganti Nomogram: One Threshold Does Not Fit All.
Article in International braz j urol : official journal of the Brazilian Society of Urology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe 2019 Briganti nomogram is widely used to guide the indication for pelvic lymph node dissection (LND) at the time of radical prostatectomy in patients with localized prostate cancer. Although previously validated, its generalizability across distinct clinical settings remains uncertain. MATERIALS AND
methodsWe conducted a multicentre external validation of the nomogram in 481 patients from three French academic institutions (Centre A n=198, Centre B n=183 and Centre C n=100). Discrimination, calibration, and clinical utility were assessed. Spared LNDs and missed lymph node invasions (LNIs) were evaluated across risk thresholds.
resultsThe overall area under the receiver operating characteristics curve (AUC) was 0.733 but varied across centres (0.580-0.768). Calibration was acceptable overall but showed systematic overestimation in low-prevalence centres. At the 7% recommended threshold, the proportion of spared LNDs ranged from 51% to 76%, while missed LNIs ranged from 0% to 8.9%. Decision curve analysis revealed that the optimal threshold differed between centres.
conclusionsThese results underscore the need for local validation and population-specific threshold adjustment before clinical implementation. Fixed thresholds may lead to under- or overtreatment depending on institutional case mix. Nomogram-based decision-making should be individualized based on local performance and patient-centred risk tolerance.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.