Study of diagnostic accuracy of Fagan’s two-step nomogram in increasing the value of predictive tools for prostate cancer: application of specific spatial distribution of positive/negative bioptic cores to predict extracapsular extension

Moro, Fabrizio; Prayer-Galetti, Tommaso; Angelini, Lorenzo; Vianello, Fábio; Gardiman, Marina Paola; Zattoni, Filiberto

doi:10.1007/s40520-018-0949-2

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…The primary aim of the study was to test the improvement in the prediction of ECE-according to Partin Tables given a particular condition at prostate biopsy (pericapsular cores uninvolved by PCa). In conclusion, authors found that the post-test probability of having ECE-when all lateral cores (ie pericapsular cores) were negative was 14.1%, with a substantial gain of 7.5% as compared to Partin estimates for ECE-(21.6%) [18].…”

Section: Clinical Use Of Fagan's Two-step Nomogrammentioning

confidence: 78%

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Tailoring nomograms on patients and institutions: The utility of Fagan's two-step nomogram

Prayer-Galetti¹,

Soligo²,

Iafrate³

et al. 2018

Geriatr Med Care

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Besides oncologic outcomes, functional outcomes (preservation of potency and early recovery of the pre-operative urinary continence) are the two main goals of radical prostatectomy. Tailoring the most appropriate but also the most conservative surgery in patients with low or intermediate risk prostate cancer is one of the hottest topic in urologic oncology nowdays. A number of nomograms, risk calculators and graphic tools have been developed to gather data from biopsy, blood samples and radiologic imaging and help clinicians to find the best balance between oncologic and functional goals.

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Section: Clinical Use Of Fagan's Two-step Nomogrammentioning

confidence: 78%

“…Another way to address the same issue requires to focus on statistics, as in Dal Moro et al which resumed an old-fashioned but user-friendly graphic calculator (Fagan's two-step nomogram) to predict the risk of ECE+ vs ECE-at radical prostatectomy, given the number of positive lateral cores at biopsy [18].…”

Section: Clinical Use Of Fagan's Two-step Nomogrammentioning

confidence: 99%

Tailoring nomograms on patients and institutions: The utility of Fagan's two-step nomogram

Prayer-Galetti¹,

Soligo²,

Iafrate³

et al. 2018

Geriatr Med Care

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“…The forest plots of validation cohorts for MRI-inclusive and clinical nomograms are presented in Supplementary Figures S1 - S4 . In the subgroup analysis, eight external validations of the Partin table [ 50 , 51 , 53 – 55 , 59 , 61 , 62 ] showed a pooled AUC of 0.72(95% CI: 0.68, 0.76), and 5 external validations of the MSKCC nomogram [ 55 , 58 , 60 – 62 ] showed a pooled AUC of 0.79(95% CI: 0.75, 0.82).…”

Section: Resultsmentioning

confidence: 99%

Diagnostic performance of prediction models for extraprostatic extension in prostate cancer: a systematic review and meta-analysis

Zhu,

Gao,

Han

et al. 2023

Insights Imaging

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Purpose In recent decades, diverse nomograms have been proposed to predict extraprostatic extension (EPE) in prostate cancer (PCa). We aimed to systematically evaluate the accuracy of MRI-inclusive nomograms and traditional clinical nomograms in predicting EPE in PCa. The purpose of this meta-analysis is to provide baseline summative and comparative estimates for future study designs. Materials and methods The PubMed, Embase, and Cochrane databases were searched up to May 17, 2023, to identify studies on prediction nomograms for EPE of PCa. The risk of bias in studies was assessed by using the Prediction model Risk Of Bias ASsessment Tool (PROBAST). Summary estimates of sensitivity and specificity were obtained with bivariate random-effects model. Heterogeneity was investigated through meta-regression and subgroup analysis. Results Forty-eight studies with a total of 57 contingency tables and 20,395 patients were included. No significant publication bias was observed for either the MRI-inclusive nomograms or clinical nomograms. For MRI-inclusive nomograms predicting EPE, the pooled AUC of validation cohorts was 0.80 (95% CI: 0.76, 0.83). For traditional clinical nomograms predicting EPE, the pooled AUCs of the Partin table and Memorial Sloan Kettering Cancer Center (MSKCC) nomogram were 0.72 (95% CI: 0.68, 0.76) and 0.79 (95% CI: 0.75, 0.82), respectively. Conclusion Preoperative risk stratification is essential for PCa patients; both MRI-inclusive nomograms and traditional clinical nomograms had moderate diagnostic performance for predicting EPE in PCa. This study provides baseline comparative values for EPE prediction for future studies which is useful for evaluating preoperative risk stratification in PCa patients. Critical relevance statement This meta-analysis firstly evaluated the diagnostic performance of preoperative MRI-inclusive nomograms and clinical nomograms for predicting extraprostatic extension (EPE) in prostate cancer (PCa) (moderate AUCs: 0.72–0.80). We provide baseline estimates for EPE prediction, these findings will be useful in assessing preoperative risk stratification of PCa patients. Key points • MRI-inclusive nomograms and traditional clinical nomograms had moderate AUCs (0.72–0.80) for predicting EPE. • MRI combined clinical nomogram may improve diagnostic accuracy of MRI alone for EPE prediction. • MSKCC nomogram had a higher specificity than Partin table for predicting EPE. • This meta-analysis provided baseline and comparative estimates of nomograms for EPE prediction for future studies. Graphical Abstract

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“…The bivariate effect model was used to combine statistics such as SEN, SPE, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) with 95% confidence intervals (CIs), plot summary receiver operating characteristic (SROC) curve, and to calculate the value of area under the curve (AUC). Fagan's nomogram was used to evaluate the a priori probability and a posteriori probability of PET / CT in distinguishing the two tumors ( 12 ). A sensitivity analysis was used to evaluate the stability of the results, and the Deek's test was used to judge the presence of bias in the study ( 13 ).…”

Section: Methodsmentioning

confidence: 99%

Use of 18F-FDG-PET/CT in differential diagnosis of primary central nervous system lymphoma and high-grade gliomas: A meta-analysis

Zhang

Li²,

Hui³

2022

Front. Neurol.

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BackgroundPrimary central nervous system lymphoma (PCNSL) and high-grade glioma (HGG) appear similar under imaging. However, since the two tumors vary in their treatment methods, their differential diagnosis is crucial. The use of 18F-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) imaging to effectively distinguish between the two tumors is not clear; therefore, a meta-analysis was carried out to determine its effectiveness.Materials and methodsThe databases PubMed, EMBASE, Cochrane, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, China Science, and Technology Journal Database (CQVIP) were exhaustively searched using stringent inclusion and exclusion criteria to select high-quality literature. The Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) was used for the qualitative assessment of the included literature. The bivariate effect model was used to combine statistics such as sensitivity (SEN) and specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) [95% confidence intervals (CI)], plot summary receiver operating characteristic (SROC) curve, and calculate the area under the curve (AUC) value. Sensitivity analysis was used to evaluate the stability of the results, and Deek's test was used to assess publication bias. Meta-regression and subgroup analysis was used to determine the sources of heterogeneity.ResultsA total of nine studies were included in this study. For differential diagnosis of PCNSL and HGG, the combined SEN was 0.91 (95% CI: 0.80–0.96; I2 = 46.73%), combined SPE was 0.88 (95% CI: 0.82–0.93; I2 = 56.30%), the combined PLR was 7.83 (95% CI: 4.96–12.37; I2 = 15.57%), combined NLR was 0.10 (95% CI: 0.05–0.23; I2 = 31.99%), combined DOR was 77.36 (95% CI: 32.74–182.77; I2 = 70.70%). The AUC of SROC was 0.95 (95% CI: 0.93–0.97). No publication bias was found and the sample size and different parameters were the primary reason for heterogeneity.ConclusionThe 18F-FDG-PET/CT imaging technique has a high diagnostic accuracy in the differential diagnosis of PNCSL and HGG. Patients suspected to have the above two tumors are suggested to be examined by 18F-FDG-PET / CT to help in the clinical distinction and further treatment modalities.

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Study of diagnostic accuracy of Fagan’s two-step nomogram in increasing the value of predictive tools for prostate cancer: application of specific spatial distribution of positive/negative bioptic cores to predict extracapsular extension

Abstract: This pioneering study may justify the use of the above nomogram in testing "local" predictive parameters in combination with pre-existing nomograms.

Cited by 4 publications

References 23 publications

Tailoring nomograms on patients and institutions: The utility of Fagan's two-step nomogram

Tailoring nomograms on patients and institutions: The utility of Fagan's two-step nomogram

Diagnostic performance of prediction models for extraprostatic extension in prostate cancer: a systematic review and meta-analysis

Use of 18F-FDG-PET/CT in differential diagnosis of primary central nervous system lymphoma and high-grade gliomas: A meta-analysis

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