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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

Calibration of the nomogram-2 prediction model when predicting (A) any and (B) high grade cancer. Perfect predictions correspond to the line with a slope of 1 (if the predictive model were perfect, triangles would lie on the 45° dotted line).
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f2-pi_1-2-69-04: Calibration of the nomogram-2 prediction model when predicting (A) any and (B) high grade cancer. Perfect predictions correspond to the line with a slope of 1 (if the predictive model were perfect, triangles would lie on the 45° dotted line).

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)

Calibration of the nomogram-2 prediction model when predicting (A) any and (B) high grade cancer. Perfect predictions correspond to the line with a slope of 1 (if the predictive model were perfect, triangles would lie on the 45° dotted line).
© Copyright Policy
Related In: Results  -  Collection

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

f2-pi_1-2-69-04: Calibration of the nomogram-2 prediction model when predicting (A) any and (B) high grade cancer. Perfect predictions correspond to the line with a slope of 1 (if the predictive model were perfect, triangles would lie on the 45° dotted line).
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