Volume 61, Issue 3, Pages 480-487 (March 2012) Updated Nomogram Predicting Lymph Node Invasion in Patients with Prostate Cancer Undergoing Extended Pelvic Lymph Node Dissection: The Essential Importance of Percentage of Positive Cores  Alberto Briganti, Alessandro Larcher, Firas Abdollah, Umberto Capitanio, Andrea Gallina, Nazareno Suardi, Marco Bianchi, Maxine Sun, Massimo Freschi, Andrea Salonia, Pierre I. Karakiewicz, Patrizio Rigatti, Francesco Montorsi  European Urology  Volume 61, Issue 3, Pages 480-487 (March 2012) DOI: 10.1016/j.eururo.2011.10.044 Copyright © 2011 European Association of Urology Terms and Conditions

Fig. 1 Nomogram predicting the probability of lymph nodes invasion (LNI) in patients undergoing extended pelvic lymphadenectomy based on pretreatment prostate-specific antigen (PSA), clinical stage, primary and secondary biopsy Gleason score, and percentage of positive cores. Instructions: Locate the patient's pretreatment PSA on the PSA axis. Draw a line straight upward to the point axis to determine how many points toward the probability of positive lymph nodes the patient receives for his PSA value. Repeat the process for each additional variable. Sum the points for each of the predictors. Locate the final sum on the total point axis. Draw a line straight down to find the patient's probability of having LNI. European Urology 2012 61, 480-487DOI: (10.1016/j.eururo.2011.10.044) Copyright © 2011 European Association of Urology Terms and Conditions

Fig. 2 Nomogram calibration plot. Dotted line indicates location of the ideal nomogram, in which predicted and actual probabilities are identical. Broken line indicates actual nomogram performance. Expected performance on future data is represented through the solid line. Calibration was tested for both models, with or without percentage of positive cores (PCC) (full and base model, respectively). European Urology 2012 61, 480-487DOI: (10.1016/j.eururo.2011.10.044) Copyright © 2011 European Association of Urology Terms and Conditions

Fig. 3 Decision curve analyses demonstrating the net benefit associated with the use of the nomogram with (model 2: full model) or without (model 1: base model) the inclusion of the percentage of positive cores as covariate. Net benefit can be interpreted as the proportion of all patients who have lymph node metastases and are recommended for extended pelvic lymph node dissection if no patients with negative lymph nodes were treated. European Urology 2012 61, 480-487DOI: (10.1016/j.eururo.2011.10.044) Copyright © 2011 European Association of Urology Terms and Conditions