Briganti’s 2012 nomogram is an independent predictor of prostate cancer progression in EAU intermediate-risk class - results from 527 patients treated with robotic surgery

Q: What was the study objective regarding Briganti’s 2012 nomogram?

To determine whether Briganti’s 2012 nomogram is associated with prostate cancer progression in EAU intermediate-risk patients treated with robotic surgery.

Q: How many patients were included and what risk group was analyzed?

The study analyzed 527 consecutive patients in the EAU intermediate-risk class with available follow-up who underwent robotic surgery.

Q: How was disease progression defined and assessed statistically?

Progression was defined as biochemical recurrence and/or metastatic progression, evaluated using Cox proportional hazards with univariate and multivariate analysis.

Sep 21, 2026

Uploaded by Evangeline

Study design evaluated whether Briganti’s 2012 nomogram predicts prostate cancer (PCa) progression in European Association of Urology (EAU) intermediate-risk patients treated with robotic surgery. From January 2013 to December 2021, 527 consecutive eligible patients were selected, excluding androgen deprivation and prior active treatments. Briganti’s 2012 score for pelvic lymph node invasion risk was tested as continuous and dichotomous (median 3.0%) using Cox proportional hazards. After median 95 months follow-up, 108 events (20.5%) occurred, and higher nomogram scores independently associated with progression.

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Introduction

Patients and Methods

EAU intermediate-risk cohort treated with robotic surgery

Prostate Cancer Open Access INVITED ORIGINAL ARTICLE Briganti’s 2012 nomogram is an independent predictor of prostate cancer progression in EAU intermediate-risk class: results from 527 patients treated with robotic surgery Antonio Benito Porcaro1, Francesca Montanaro1, Alberto Baielli1, Francesco Artoni1, Claudio Brancelli1, Sonia Costantino1, Andrea Franceschini1, Sebastian Gallina1, Alberto Bianchi1, Emanuele Serafin1, Alessandro Veccia1, Riccardo Rizzetto1, Matteo Brunelli2, Filippo Migliorini1, Salvatore Siracusano3, Maria Angela Cerruto1, Riccardo Giuseppe Bertolo1, Alessandro Antonelli1 The study aimed to test if Briganti’s 2012 nomogram could be associated with the risk of prostate cancer (PCa) progression in European Association of Urology (EAU) intermediate-risk patients treated with robotic surgery. From January 2013 to December 2021, 527 consecutive patients belonging to the EAU intermediate-risk class were selected. Briganti’s 2012 nomogram, which predicts the risk of pelvic lymph node invasion (PLNI), was assessed as a continuous and dichotomous variable that categorized up to the median of 3.0% . Disease progression defined as biochemical recurrence and/or metastatic progression was evaluated by Cox proportional hazards (univariate and multivariate analysis). After a median follow-up of 95.0 months (95% confidence interval [CI]: 78.5–111.4), PCa progression occurred in 108 (20.5%) patients who were more likely to present with an unfavorable nomogram risk score, independently by the occurrence of unfavorable pathology including tumor upgrading and upstaging as well as PLNI. Accordingly, as Briganti’s 2012 risk score increased, patients were more likely to experience disease progression (hazard ratio [HR] = 1.060; 95% CI: 1.021–1.100; P = 0.002); moreover, it also remained significant when dichotomized above a risk score of 3.0%(HR = 2.052; 95% CI: 1.298–3.243; P < 0.0001) after adjustment for clinical factors. In the studied risk population, PCa progression was independently predicted by Briganti’s 2012 nomogram. Specifically, we found that patients were more likely to experience disease progression as their risk score increased. Because of the significant association between risk score and tumor behavior, the nomogram can further stratify intermediate-risk PCa patients, who represent a heterogeneous risk category for which different treatment paradigms exist. Asian Journal of Andrology (2024) 26 , 587–591; doi: 10.4103/aja202439; published online: 30 July 2024 Keywords: biochemical recurrence; Briganti’s 2012 nomogram; intermediate-risk prostate cancer; pelvic lymph node invasion; prostate cancer progression; robot-assisted radical prostatectomy INTRODUCTION Clinical prostate cancer (PCa) is a widespread problem of such magnitude to force both the European Association of Urology (EAU) and the National Comprehensive Cancer Network (NCCN) to continuously update their guidelines to give the urology community the best recommendations to treat the disease and avoid overtreatments, which has an important impact on patient’s quality of life.1–4 Clinical class risks are calculated using parameters including prostate-specific antigen (PSA), tumor stage, and grade according to the International Society of Urologic Pathology (ISUP) . 1,2 In both systems, the intermediate-risk class is the most heterogeneous and controversial one because it includes the largest group of patients that might present with PSA levels between 10 ng ml−1 and 20 ng ml−1 and/or ISUP tumor grade group 2–3 and/or clinical tumor stage cT2, which is up to cT-2bor cT-2c according to EAU and NCCN, respectively. Furthermore, this group is subdivided into favorable and unfavorable categories, the latter requiring active treatment if patients’ life expectancy exceeds 10 years. Active treatment includes surgery, which is more commonly performed by robot-assisted radical prostatectomy (RARP) eventually associated with extended pelvic lymph

FAQs

What was the study objective regarding Briganti’s 2012 nomogram?

To determine whether Briganti’s 2012 nomogram is associated with prostate cancer progression in EAU intermediate-risk patients treated with robotic surgery.

How many patients were included and what risk group was analyzed?

The study analyzed 527 consecutive patients in the EAU intermediate-risk class with available follow-up who underwent robotic surgery.

How was disease progression defined and assessed statistically?

Progression was defined as biochemical recurrence and/or metastatic progression, evaluated using Cox proportional hazards with univariate and multivariate analysis.

Sep 21, 2026

Uploaded by Evangeline