title: A nomogram is more accurate than a regression tree in predicting lymph node invasion in prostate cancer.
abstract: OBJECTIVE
  To compare the performance and discriminant properties of two instruments (a tree-structured regression model and a logistic regression-based nomogram), recently developed to predict lymph node invasion (LNI) at radical prostatectomy (RP), in a contemporary cohort of European patients.
  
  
  METHODS
  The cohort comprised 1525 consecutive men treated with RP and bilateral pelvic LN dissection (PLND) in two tertiary academic centres in Europe. Clinical stage, pretreatment prostate-specific antigen (PSA) level and biopsy Gleason sum were used to test the ability of the regression tree and the nomogram to predict LNI. Accuracy was quantified by the area under the receiver operating characteristic curve (AUC). All analyses were repeated for each participating institution.
  
  
  RESULTS
  The AUC for the nomogram was 81%, vs 77% for the regression tree (P = 0.007). When data were stratified according to institution, the nomogram invariably had a higher AUC than the regression tree (Hamburg cohort: nomogram 82.1% vs regression tree 77.0%, P = 0.002; Milan cohort: 82.4% vs 75.9%, respectively; P = 0.03).
  
  
  CONCLUSIONS
  Nomogram-based predictions of LNI were more accurate than those derived from a regression tree; therefore, we recommend the use of nomogram-derived predictions.
authors.affiliation: Department of Urology, Vita-Salute University, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallina
authors.forename: Nazareno
authors.initials: N
authors.lastname: Suardi
authors.forename: Felix K-H
authors.initials: FK
authors.lastname: Chun
authors.forename: Jochen
authors.initials: J
authors.lastname: Walz
authors.forename: Roman
authors.initials: R
authors.lastname: Heuer
authors.forename: Andrea
authors.initials: A
authors.lastname: Salonia
authors.forename: Alexander
authors.initials: A
authors.lastname: Haese
authors.forename: Paul
authors.initials: P
authors.lastname: Perrotte
authors.forename: Luc
authors.initials: L
authors.lastname: Valiquette
authors.forename: Markus
authors.initials: M
authors.lastname: Graefen
authors.forename: Patrizio
authors.initials: P
authors.lastname: Rigatti
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.forename: Hartwig
authors.initials: H
authors.lastname: Huland
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003663:Decision Trees; D005060:Europe; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D049451:Nomograms; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012015:Reference Standards; D012044:Regression Analysis
chemical_list: D017430:Prostate-Specific Antigen