2054 REDUCING UNNECESSARY BIOPSIES FOR SUSPICION OF PROSTATE CANCER: EXTENSION AND VALIDATION OF AN ERSPC BASED RISK CALCULATOR WITH PHI AND COMPARISON WITH THE PCPT RISK CALCULATOR INCLUDING %FREE AND -2PROPSA

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You have accessJournal of UrologyProstate Cancer: Detection & Screening (IV)1 Apr 20132054 REDUCING UNNECESSARY BIOPSIES FOR SUSPICION OF PROSTATE CANCER: EXTENSION AND VALIDATION OF AN ERSPC BASED RISK CALCULATOR WITH PHI AND COMPARISON WITH THE PCPT RISK CALCULATOR INCLUDING %FREE AND -2PROPSA Monique J. Roobol, Daan Nieboer, Alain Houlgatte, Sebastien Vincendeau, Massimo Lazzeri, Giorgio Guazzoni, Carsten Stephan, Axel Semjonow, Alexander Haese, Markus Graefen, and Ewout W Steyerberg Monique J. RoobolMonique J. Roobol Rotterdam, Netherlands More articles by this author , Daan NieboerDaan Nieboer Rotterdam, Netherlands More articles by this author , Alain HoulgatteAlain Houlgatte Paris, France More articles by this author , Sebastien VincendeauSebastien Vincendeau Rennes, France More articles by this author , Massimo LazzeriMassimo Lazzeri Milan, Italy More articles by this author , Giorgio GuazzoniGiorgio Guazzoni Milan, Italy More articles by this author , Carsten StephanCarsten Stephan Berlin, Germany More articles by this author , Axel SemjonowAxel Semjonow Munster, Germany More articles by this author , Alexander HaeseAlexander Haese Hamburg, Germany More articles by this author , Markus GraefenMarkus Graefen Hamburg, Macedonia More articles by this author , and Ewout W SteyerbergEwout W Steyerberg Rotterdam, Netherlands More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2473AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Individual multivariable risk assessment tools like the DRE based risk calculator (DRE_RC) (www.prostatecancer-riskcalculator.com) can be of aid in reducing unnecessary biopsies (Bx). Here we assess the incremental value of different PSA sub forms to this risk prediction tool and compare its performance with the PCPT RC including %free- and pro-PSA. METHODS As a first validation set, we studied 615 men with no previous Bx (353 (57%) having PC) and 272 men with previous Bx (113 (42%) having PC) coming from 4 European sites (Paris, Rennes, Berlin and Munster). All men had T-PSA between 1.6-8.0 ng/ml (WHO calibration). We used ROC analysis to assess the value of -2proPSa, % -2proPSA and Phi in addition to the linear predictor of DRE_RC # 3 (no previous Bx) and DRE_RC #4 (yes previous Bx) in a logistic regression model. We subsequently developed extended versions of the RC#3 and RC#4 using likelihood ratios from the 4 European cohorts in addition to the original RC's [1,2]. For the validation of the extended prediction tools (RC#3_Phi and RC#4_Phi) we studied an independent dataset (Milan and Hamburg) consisting of 950 men with 404 PC cases detected (with 322 men (with 117 PC cases) previously biopsied)). Outcomes were a biopsy detectable PC as well as having a biopsy detectable potentially advanced or aggressive PC defined as a clinical stage > T2B and / or a biopsy Gleason score >= 7 (PCserious). RESULTS We found that additional information next to PSA alone increased predictive ability of biopsy outcomes (Table). The addition of Phi to the DRE based RC had the largest improvement in AUC. The newly developed RC3_Phi and RC4_Phi showed good discrimination in the second validation dataset with significant increase in AUC in men not previously biopsied and outperformed the PCPT RC. CONCLUSIONS Inclusion of Phi results in a clear increase in predictive ability of the previously developed ERSPC DRE based Risk calculators #3 and # 4. This may lead to important further reductions of unnecessary prostate biopsies, one of the major drawbacks of current screening for PC. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLoeb S, Sanda M, Broyles D, Shin S, Bangma C, Wei J, Partin A, Klee G, Slawin K, Marks L, van Schaik R, Chan D, Sokoll L, Cruz A, Mizrahi I and Catalona W (2018) The Prostate Health Index Selectively Identifies Clinically Significant Prostate CancerJournal of Urology, VOL. 193, NO. 4, (1163-1169), Online publication date: 1-Apr-2015. Volume 189Issue 4SApril 2013Page: e843 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Monique J. Roobol Rotterdam, Netherlands More articles by this author Daan Nieboer Rotterdam, Netherlands More articles by this author Alain Houlgatte Paris, France More articles by this author Sebastien Vincendeau Rennes, France More articles by this author Massimo Lazzeri Milan, Italy More articles by this author Giorgio Guazzoni Milan, Italy More articles by this author Carsten Stephan Berlin, Germany More articles by this author Axel Semjonow Munster, Germany More articles by this author Alexander Haese Hamburg, Germany More articles by this author Markus Graefen Hamburg, Macedonia More articles by this author Ewout W Steyerberg Rotterdam, Netherlands More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...