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 scoreā„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.
Written by:
Jeong IG, Lim JH, Hwang SS, Kim SC, You D, Hong JH, Ahn H, Kim CS. Are you the author?
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Reference: Prostate Int. 2013;1(2):69-75.
doi: 10.12954/PI.12008
PubMed Abstract
PMID: 24223405
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