Calculate Estimated Lymph Node Invasion Risk
Enter biopsy and clinical details below to generate a Briganti-style risk estimate. This tool is for educational use and should not replace specialist medical advice.
Clinical practice often uses cutoffs (such as 5% or 7%) to guide decisions about extended pelvic lymph node dissection (ePLND), but final decisions should be made with your treating urologist.
What is the Briganti score?
The Briganti score is a risk model used in prostate cancer care to estimate the probability of lymph node invasion (LNI) at the time of surgery. In practical terms, it helps clinicians assess whether pelvic lymph node dissection should be considered during radical prostatectomy.
Different Briganti nomogram versions exist, and each version uses slightly different variables. Commonly used inputs include PSA, clinical stage, biopsy grade, and extent of cancer in biopsy cores.
How this calculator works
This page uses a Briganti-style logistic model to provide a quick estimate from five common pre-operative factors:
- PSA level
- Clinical T stage
- Biopsy Grade Group (ISUP)
- Number of positive cores
- Total number of cores
The tool converts your data into an estimated probability (%). Higher percentages indicate higher predicted risk of lymph node involvement.
Interpreting the result
- Low risk: generally below 5%
- Intermediate risk: roughly 5% to 20%
- Higher risk: above 20%
Some centers use a 7% threshold as one decision point for considering ePLND. Others may use 5% or institution-specific pathways.
Why this matters in treatment planning
Pelvic lymph node dissection can improve staging accuracy and guide post-operative treatment discussions. However, it is still surgery and may add operative time, risk of lymphocele, bleeding, or other complications. A risk score helps balance the likely benefit against those risks.
Key clinical context
No single score should be used in isolation. Real-world decision-making combines:
- MRI findings and lesion characteristics
- Pathology detail beyond basic grade group
- Comorbidities and anesthesia risk
- Patient preferences and quality-of-life priorities
Example scenario
Suppose a patient has PSA 10.2 ng/mL, clinical stage T2, Grade Group 3, and 5 positive cores out of 12 total. The calculator may return a mid-range probability where ePLND discussion is clinically reasonable.
If a different patient has PSA 4.8 ng/mL, stage T1, Grade Group 1, and 1 of 12 cores positive, the estimated risk is often much lower, and many teams may avoid lymph node dissection.
Important limitations
- This is an educational estimator, not a diagnostic device.
- It does not replace formal nomogram software or specialist interpretation.
- It does not include every variable used in modern MRI-integrated models.
- Local guideline differences can change how thresholds are applied.
Bottom line
A Briganti score calculator is most useful as a structured conversation starter: it quantifies risk, supports shared decision-making, and helps frame whether additional nodal surgery is likely to provide value in your specific case.