需要对前列腺癌（PCa）患者进行盆腔淋巴结转移病（pN1）的术前评估，以确定是否有资格接受扩展盆腔淋巴结清扫（ePLND）。使用术前临床和组织病理学参数、磁共振成像（MRI）和前列腺特异性膜抗原（PSMA）正电子发射断层扫描（PET）开发一种新的直观预后评分表，用于预测初诊局部PCa患者的病理淋巴结（pN）状态。总共有700名接受机器人辅助根治性前列腺切除术和ePLND的符合条件的患者被包括在模型建立队列中。外部验证队列包括305名接受手术治疗的患者。采用逐步回归法选择变量，构建Amsterdam-Brisbane-Sydney评分表。使用接受者操作特征曲线下面积（AUC）、校准图和决策曲线分析评估最终模型的性能。模型随后在外部人群中得到验证。Amsterdam-Brisbane-Sydney评分表包括最初的前列腺特异性抗原值、MRI T分期、最高活检等级组（GG）、活检技术、临床意义PCa的系统性发现核心的百分比（GG≥2），以及PSMA-PET上的淋巴结状态。预测pN状态的AUC为0.81（95%置信区间[CI] 0.78-0.85）。在外部验证中，Amsterdam-Brisbane-Sydney评分表显示出比Briganti-2017和Memorial Sloan Kettering Cancer Center（MSKCC）评分表具有更优越的判别能力（AUC 0.75 [95% CI 0.69-0.81] vs 0.67 [95% CI 0.61-0.74]和0.65 [95% CI 0.58-0.72]，p<0.05），并且与Briganti-2019评分表的判别能力相似（AUC 0.78 [95% CI 0.71-0.86] vs 0.80 [95% CI 0.73-0.86]；p=0.76）。Amsterdam-Brisbane-Sydney评分表在外部验证中的校准表现出色，在阈值概率≥4%时具有增加的净收益。验证过的Amsterdam-Brisbane-Sydney评分表的性能优于Briganti-2017和MSKCC评分表，与Briganti-2019评分表相似或更好。此外，它适用于所有新诊断的不利中高危PCa患者。我们开发并验证了Amsterdam-Brisbane-Sydney评分表，用于预测手术前前列腺癌的淋巴结转移。该评分表的表现与目前所有可用的评分表相似或更优。版权所有©2023作者。Elsevier B.V.保留所有权利。

Preoperative assessment of the probability of pelvic lymph-node metastatic disease (pN1) is required to identify patients with prostate cancer (PCa) who are candidates for extended pelvic lymph-node dissection (ePLND).To develop a novel intuitive prognostic nomogram for predicting pathological lymph-node (pN) status in contemporary patients with primary diagnosed localized PCa, using preoperative clinical and histopathological parameters, magnetic resonance imaging (MRI), and prostate-specific membrane antigen (PSMA) positron emission tomography (PET).In total, 700 eligible patients who underwent robot-assisted radical prostatectomy and ePLND were included in the model-building cohort. The external validation cohort consisted of 305 surgically treated patients. Logistic regression with backward elimination was used to select variables for the Amsterdam-Brisbane-Sydney nomogram.Performance of the final model was evaluated using the area under the receiver operating characteristic curve (AUC), calibration plots, and decision-curve analyses. Models were subsequently validated in an external population.The Amsterdam-Brisbane-Sydney nomogram included initial prostate-specific antigen value, MRI T stage, highest biopsy grade group (GG), biopsy technique, percentage of systematic cores with clinically significant PCa (GG ≥2), and lymph-node status on PSMA-PET. The AUC for predicting pN status was 0.81 (95% confidence interval [CI] 0.78-0.85) for the final model. On external validation, the Amsterdam-Brisbane-Sydney nomogram showed superior discriminative ability to the Briganti-2017 and Memorial Sloan Kettering Cancer Center (MSKCC) nomograms (AUC 0.75 [95% CI 0.69-0.81] vs 0.67 [95% CI 0.61-0.74] and 0.65 [95% CI 0.58-0.72], respectively; p < 0.05), and similar discriminative ability to the Briganti-2019 nomogram (AUC 0.78 [95% CI 0.71-0.86] vs 0.80 [95% CI 0.73-0.86]; p = 0.76). The Amsterdam-Brisbane-Sydney nomogram showed excellent calibration on external validation, with an increased net benefit at a threshold probability of ≥4%.The validated Amsterdam-Brisbane-Sydney nomogram performs superior to the Briganti-2017 and MSKCC nomograms, and similar to the Briganti-2019 nomogram. Furthermore, it is applicable in all patients with newly diagnosed unfavorable intermediate- and high-risk PCa.We developed and validated the Amsterdam-Brisbane-Sydney nomogram for the prediction of prostate cancer spread to lymph nodes before surgery. This nomogram performs similar or superior to all presently available nomograms.Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.