External validation of the Memorial Sloan Kettering Cancer Center preoperative nomogram predicting lymph node invasion in a cohort of high-grade prostate cancer patients.

BACKGROUND: Commonly used preoperative nomograms predicting clinical and pathological outcomes in prostate cancer (PCa) patients have not been yet validated in high-grade only PCa patients. Our objective is to perform an external validation of the Memorial Sloan Kettering Cancer Center (MSKCC) preoperative nomogram as a predictor of lymph node invasion (LNI) in a cohort of high-grade PCa patients. METHODS: We included patients with high-grade PCa (Gleason ≥8) treated at our institution between 2011 and 2020 with radical prostatectomy and pelvic lymph node dissection without receiving neoadjuvant or adjuvant therapy. The area under the curve (AUC) of the receiver operator characteristic (ROC) was used to quantify the accuracy of the model to predict LNI. A calibration plot was used to evaluate the model's precision, and a decision curve analysis was computed to evaluate the net benefit associated with its use. This study was approved by our institution's ethics board. RESULTS: A total of 242 patients with a median age of 66 (60-71) years were included. LNI was observed in 70 (29%) patients with a mean of 16 (median = 15; range = 2-42) resected nodes. The MSKCC nomogram discriminative accuracy, as evaluated by the AUC-ROC was 79.0% (CI: [0.727-0.853]). CONCLUSION: The MSKCC preoperative nomogram is a good predictor of LNI and a useful tool associated with net clinical benefit in this patient population.

10-W-level monolithic dysprosium-doped fiber laser at 3.24 µm.

We report, to the best of our knowledge, the first entirely monolithic dysprosium (Dy)-doped fluoride fiber laser operating in the mid-IR region. The system delivers 10.1 W at 3.24 µm in continuous operation, a record for fiber oscillators in this range of wavelengths. The Dy3+ fiber is pumped in-band using an erbium-doped fiber laser at 2.83 µm made in-house and connected through a fusion splice. Two fiber Bragg gratings directly written in the Dy-doped fiber form the 3.24 µm laser cavity to provide a spectrally controlled laser output. This substantial increase of output power in the 3.0-3.3 µm spectral range could open new possibilities for applications in spectroscopy and advanced manufacturing.