What is lymph node involvement (LNI) in prostate cancer?

Lymph node involvement (LNI) refers to the spread of prostate cancer cells to nearby lymph nodes in the pelvis. This is an important prognostic factor that influences treatment decisions, particularly whether to perform pelvic lymph node dissection during surgery or include pelvic lymph nodes in radiation therapy fields.

What is the MSKCC nomogram for prostate cancer?

The MSKCC (Memorial Sloan Kettering Cancer Center) nomogram is a validated prediction tool that estimates the probability of lymph node involvement in prostate cancer patients. It uses clinical variables including PSA level, clinical stage, Gleason grade group, and percentage of positive biopsy cores to calculate LNI risk.

What is the Briganti nomogram?

The Briganti nomogram is a European-validated model for predicting lymph node involvement in prostate cancer. Multiple versions exist (2012, 2017, 2019) with progressively refined inputs. The 2019 version incorporates MRI findings and can include PSA density and maximum cancer percentage per core for improved accuracy.

What is the Roach formula for LNI risk?

The Roach formula is a simple calculation for estimating lymph node involvement risk: LNI% = (2/3 × PSA) + (Gleason score - 6) × 10. It provides a quick estimation when detailed nomogram inputs are unavailable, though it is less accurate than modern nomograms.

When should pelvic lymph node dissection be performed?

Guidelines generally recommend: LNI risk less than 5% - extended PLND often omitted; LNI risk 5-20% - consider extended PLND based on patient factors; LNI risk greater than 20% - extended PLND strongly recommended. These thresholds may vary by institution and guidelines (NCCN, EAU).

How does the AI-assisted data extraction work?

The calculator uses Google's Gemini AI to parse clinical text such as pathology reports, urology notes, or imaging reports. It automatically extracts relevant parameters like PSA, Gleason score, clinical stage, and biopsy core data, reducing manual data entry and potential transcription errors.

Prostate Cancer LNI Risk Calculator

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This tool helps clinicians assess the risk of lymph node involvement in prostate cancer patients using validated nomograms including MSKCC, Briganti, and Roach formula.