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Nomogram using transrectal ultrasound-derived information predicting the detection of high grade prostate cancer on initial biopsy.

Jeong IG, Lim JH, Hwang SS, Kim SC, You D, Hong JH, Ahn H, Kim CS - Prostate Int (2013)

Bottom Line: Of the 1,048 men who underwent biopsy, 216 (20.6%) were found to have any PCa, and 97 (9.3%) were found to have HGPCa.All six risk factors were found to be independent predictors for both any PCa and HGPCa.Removing the TRUS-derived information from nomogram-2 resulted in an incremental AUC decrease of 0.052 for any PCa and 0.063 for HGPCa.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To develop a nomogram using transrectal ultrasound (TRUS)-derived information for predicting high grade (HG) prostate cancer (PCa) on initial biopsy.

Methods: Data were collected on 1,048 men with serum prostate-specific antigen (PSA) levels 4.0 to 9.9 ng/mL who underwent an initial prostate biopsy. Two logistic regression-based nomograms were constructed to predict the detection of PCa. Nomogram-1 incorporated age, digital rectal examination, PSA and percent free PSA data, whereas nomogram-2 incorporated those factors plus TRUS-derived information (i.e., prostate volume and the presence of hypoechoic lesions). The prediction of any PCa and HGPCa (Gleason score≥7) were determined. Twenty percent of the data were randomly reserved for study validation, and the predictive accuracies of the two nomograms were directly compared.

Results: Of the 1,048 men who underwent biopsy, 216 (20.6%) were found to have any PCa, and 97 (9.3%) were found to have HGPCa. All six risk factors were found to be independent predictors for both any PCa and HGPCa. The area under curve (AUC) for nomogram-2 was 0.76 (95% confidence interval [CI], 0.72 to 0.81) for predicting any PCa, and 0.83 (95% CI, 0.79 to 0.88) for predicting HGPCa. These AUCs were greater than those for nomogram-1 (0.72 [95% CI, 0.68 to 0.76 for any PCa; P<0.001], 0.78 [95% CI, 0.72 to 0.83 for HGPCa; P<0.001]). Removing the TRUS-derived information from nomogram-2 resulted in an incremental AUC decrease of 0.052 for any PCa and 0.063 for HGPCa.

Conclusions: The nomogram using TRUS-derived information had a high predictive accuracy for HGPCa on initial prostate biopsy.

No MeSH data available.


Related in: MedlinePlus

Logistic-based nomogram-2 prediction model for predicting (A) any and (B) high grade prostate cancer on initial biopsy. To obtain the predicted probability of cancer, locate the patient position for each variable on the horizontal axis and determine the assigned point value. The probability value for having cancer corresponds to the summed all points scale for all variables. PSA, prostate-specific antigen; DRE, digital rectal examination; TRUS, transrectal ultrasound.
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f1-pi_1-2-69-04: Logistic-based nomogram-2 prediction model for predicting (A) any and (B) high grade prostate cancer on initial biopsy. To obtain the predicted probability of cancer, locate the patient position for each variable on the horizontal axis and determine the assigned point value. The probability value for having cancer corresponds to the summed all points scale for all variables. PSA, prostate-specific antigen; DRE, digital rectal examination; TRUS, transrectal ultrasound.

Mentions: We constructed two nomograms to predict the presence of both any PCa and HGPCa according to biopsy results. Nomogram-1 incorporated age, total PSA, percent free PSA and DRE findings, while nomogram-2 incorporated the same factors plus TRUS-derived information (prostate volume and presence of hypoechoic lesions) (Fig. 1). For nomogram-1, the total AUC for predicting any PCa was 0.72 (95% CI, 0.68 to 0.76), and for predicting HGPCa was 0.78 (95% CI, 0.72 to 0.83). For nomogram-2, the total AUC for predicting any PCa was 0.76 (95% CI, 0.72 to 0.81), and for predicting HGPCa was 0.83 (95% CI, 0.79 to 0.88). Statistical analysis showed that nomogram-2 was better than nomogram-1 at predicting the presence of both any PCa (P=0.001) and HGPCa (P<0.001). The calibration of nomogram-2 using the validation data set is shown in Fig. 2.


Nomogram using transrectal ultrasound-derived information predicting the detection of high grade prostate cancer on initial biopsy.

Jeong IG, Lim JH, Hwang SS, Kim SC, You D, Hong JH, Ahn H, Kim CS - Prostate Int (2013)

Logistic-based nomogram-2 prediction model for predicting (A) any and (B) high grade prostate cancer on initial biopsy. To obtain the predicted probability of cancer, locate the patient position for each variable on the horizontal axis and determine the assigned point value. The probability value for having cancer corresponds to the summed all points scale for all variables. PSA, prostate-specific antigen; DRE, digital rectal examination; TRUS, transrectal ultrasound.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3814113&req=5

f1-pi_1-2-69-04: Logistic-based nomogram-2 prediction model for predicting (A) any and (B) high grade prostate cancer on initial biopsy. To obtain the predicted probability of cancer, locate the patient position for each variable on the horizontal axis and determine the assigned point value. The probability value for having cancer corresponds to the summed all points scale for all variables. PSA, prostate-specific antigen; DRE, digital rectal examination; TRUS, transrectal ultrasound.
Mentions: We constructed two nomograms to predict the presence of both any PCa and HGPCa according to biopsy results. Nomogram-1 incorporated age, total PSA, percent free PSA and DRE findings, while nomogram-2 incorporated the same factors plus TRUS-derived information (prostate volume and presence of hypoechoic lesions) (Fig. 1). For nomogram-1, the total AUC for predicting any PCa was 0.72 (95% CI, 0.68 to 0.76), and for predicting HGPCa was 0.78 (95% CI, 0.72 to 0.83). For nomogram-2, the total AUC for predicting any PCa was 0.76 (95% CI, 0.72 to 0.81), and for predicting HGPCa was 0.83 (95% CI, 0.79 to 0.88). Statistical analysis showed that nomogram-2 was better than nomogram-1 at predicting the presence of both any PCa (P=0.001) and HGPCa (P<0.001). The calibration of nomogram-2 using the validation data set is shown in Fig. 2.

Bottom Line: Of the 1,048 men who underwent biopsy, 216 (20.6%) were found to have any PCa, and 97 (9.3%) were found to have HGPCa.All six risk factors were found to be independent predictors for both any PCa and HGPCa.Removing the TRUS-derived information from nomogram-2 resulted in an incremental AUC decrease of 0.052 for any PCa and 0.063 for HGPCa.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To develop a nomogram using transrectal ultrasound (TRUS)-derived information for predicting high grade (HG) prostate cancer (PCa) on initial biopsy.

Methods: Data were collected on 1,048 men with serum prostate-specific antigen (PSA) levels 4.0 to 9.9 ng/mL who underwent an initial prostate biopsy. Two logistic regression-based nomograms were constructed to predict the detection of PCa. Nomogram-1 incorporated age, digital rectal examination, PSA and percent free PSA data, whereas nomogram-2 incorporated those factors plus TRUS-derived information (i.e., prostate volume and the presence of hypoechoic lesions). The prediction of any PCa and HGPCa (Gleason score≥7) were determined. Twenty percent of the data were randomly reserved for study validation, and the predictive accuracies of the two nomograms were directly compared.

Results: Of the 1,048 men who underwent biopsy, 216 (20.6%) were found to have any PCa, and 97 (9.3%) were found to have HGPCa. All six risk factors were found to be independent predictors for both any PCa and HGPCa. The area under curve (AUC) for nomogram-2 was 0.76 (95% confidence interval [CI], 0.72 to 0.81) for predicting any PCa, and 0.83 (95% CI, 0.79 to 0.88) for predicting HGPCa. These AUCs were greater than those for nomogram-1 (0.72 [95% CI, 0.68 to 0.76 for any PCa; P<0.001], 0.78 [95% CI, 0.72 to 0.83 for HGPCa; P<0.001]). Removing the TRUS-derived information from nomogram-2 resulted in an incremental AUC decrease of 0.052 for any PCa and 0.063 for HGPCa.

Conclusions: The nomogram using TRUS-derived information had a high predictive accuracy for HGPCa on initial prostate biopsy.

No MeSH data available.


Related in: MedlinePlus