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Het ontwerpen van een nomogram gebaseerd op echo-MR-fusie biopsie dat de kans op een klinisch relevante lymfeklierdissectie voorspelt bij patiënten met een verdenking op lymfekliermetastasen ten gevolge van prostaatcarcinoom

Bax, E.A. and Matser, I. and Miessen, L.L. and Schoonbrood, M.J.P. (2019) Het ontwerpen van een nomogram gebaseerd op echo-MR-fusie biopsie dat de kans op een klinisch relevante lymfeklierdissectie voorspelt bij patiënten met een verdenking op lymfekliermetastasen ten gevolge van prostaatcarcinoom.

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Abstract:Background: The nomogram based on systematic transrectal ultrasound guided biopsy (TRUSGB) cannot be used to calculate the risk of lymph node metastases for MRI ultrasound fusion guided biopsies. Objective: To develop a nomogram based on biopsies targeted with MRI ultrasound fusion and to determine the extent to which this nomogram predicts the risk of lymph node metastases with the same or higher accuracy compared to the MSKCC nomogram in patients with suspicion of lymph node metastases as a result of prostate carcinoma Design, setting and participants: A total of 295 patients who underwent biopsies targeted with MRI ultrasound fusion and systematic TRUSGB were retrospectively identified. Method: Logistic regression was used to select a combination of parameters derived from clinical findings, multiparametric MRI and MRI ultrasound fusion guided biopsies to represent the basis of a new nomogram that predicts the clinical relevance of lymph node dissection. The new nomogram is evaluated using the area under the receiver operating characteristic curve (AUC) to determine the accuracy compared to the MSKCC nomogram. Results and limitations: Overall, lymph node dissection was clinically relevant in 53 patients (18%). PSA value, length of the lesion, location of the lesion, tumour percentage, ISUP score, clinical T stage and ADC value were significantly associated with the clinical relevance of lymph node dissection. The new nomogram had an AUC of 92,2%. Using a cut-off value of 10%, only 6 cases (3,2%) of clinically relevant lymph node dissections would be missed and 58 (55,2%) patients would undergo lymph node dissection despite it being not clinically relevant. Conclusion: A new nomogram was developed that predicts the clinical relevance of lymph node dissection. To predict the risk of lymph node metastases, a nomogram needs to be developed following the same method, using lymph node dissections as golden standard.
Item Type:Essay (Bachelor)
Faculty:TNW: Science and Technology
Subject:44 medicine, 50 technical science in general
Programme:Technical Medicine BSc (50033)
Link to this item:http://purl.utwente.nl/essays/78138
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