Development of a nomogram to predict probability of positive initial prostate biopsy among Japanese patients

Suzuki, Hiroyoshi; Komiya, Akira; Kamiya, Naoto; Igarashi, Takashi; Kawamura, Koji; Miura, Junichiro; Suzuki, Noriyuki; Nakatsu, Hiroomi; Hata, Akira; Ichikawa, Tomohiko

doi:10.1016/j.urology.2005.07.040

Cited by 66 publications

(64 citation statements)

References 19 publications

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“…While these results are similar with those reported from previous studies ( Table 3), [15][16][17][18][19] this is the first report to do so in a Chinese population, using a Chinese cohort. Recently, a systematic review comparing different models for predicting the risk of a positive prostate biopsy using PSA levels alone was reported.…”

supporting

confidence: 92%

A nomogram based on age, prostate-specific antigen level, prostate volume and digital rectal examination for predicting risk of prostate cancer

Tang¹,

Chen²,

Uhlman³

et al. 2012

Asian J Androl

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Nomograms for predicting the risk of prostate cancer developed using other populations may introduce sizable bias when applied to a Chinese cohort. In the present study, we sought to develop a nomogram for predicting the probability of a positive initial prostate biopsy in a Chinese population. A total of 535 Chinese men who underwent a prostatic biopsy for the detection of prostate cancer in the past decade with complete biopsy data were included. Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy. Age, prostate-specific antigen (PSA), prostate volume (PV), digital rectal examination (DRE) status, % free PSA and transrectal ultrasound (TRUS) findings were included in the analysis. A nomogram model was developed that was based on these independent predictors to calculate the probability of a positive initial prostate biopsy. A receiver-operating characteristic curve was used to assess the accuracy of using the nomogram and PSA levels alone for predicting positive prostate biopsy. The rate for positive initial prostate biopsy was 41.7% (223/535). The independent variables used to predict a positive initial prostate biopsy were age, PSA, PV and DRE status. The areas under the receiver-operating characteristic curve for a positive initial prostate biopsy for PSA alone and the nomogram were 79.7% and 84.8%, respectively. Our results indicate that the risk of a positive initial prostate biopsy can be predicted to a satisfactory level in a Chinese population using our nomogram. The nomogram can be used to identify and counsel patients who should consider a prostate biopsy, ultimately enhancing accuracy in diagnosing prostate cancer.

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supporting

confidence: 92%

A nomogram based on age, prostate-specific antigen level, prostate volume and digital rectal examination for predicting risk of prostate cancer

Tang¹,

Chen²,

Uhlman³

et al. 2012

Asian J Androl

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“…In Japan, PCa incidence and mortality rates are on the increase, despite efforts to screen and diagnose patients early and despite extensive efforts to treat this disease (1,2). There are a number of modalities for localized PCa.…”

Section: Introductionmentioning

confidence: 99%

The prognostic significance of loss of the androgen receptor and neuroendocrine differentiation in prostate biopsy specimens among castration-resistant prostate cancer patients

Komiya

Yasuda

Watanabe

et al. 2013

Molecular and Clinical Oncology

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Abstract. Prostate cancer (PCa) is a leading cause of mortality, and despite good response to androgen ablation this response is eventually lost. In the present study, androgen receptor (AR) expression and neuroendocrine differentiation (NED) were evaluated in hormone-sensitive (HSPC) and castration-resistant prostate cancers (CRPC). Prostate tissues were obtained from 20 HSPC patients at diagnosis and 28 CRPC patients at castration-resistant progression. AR, chromogranin A (CGA) and neuron-specific enolase (NSE) were evaluated by immunohistochemical staining (IHS) in representative positive cores for PCa. IHS intensity was graded as negative, 0; positive, 1+ and strongly positive, 2+. The proportion of the 1+ and 2+ areas in PCa cells was determined. PCa was considered to be in NED if ≥50% of the tumor cells were 1+ or 2+ for CGA or NSE. The observed IHS intensity (0/1+/2+) for AR, CGA and NSE was 0/4/16, 5/11/4 and 11/4/5 in HSPC patients and 9/3/16, 5/8/15

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“…Although it is difficult to compare various biopsy methods in terms of positive biopsy rate among previous studies because of differences in patient clinical backgrounds even in the same PSA range and possible differences in compliance of candidates for prostate biopsies at institutions (that is, selection bias during institutional decision-making on biopsy indications), the positive biopsy rates shown in the present study were comparable to or greater than those of previous studies from other institutes. [5][6][7][8][9][10][11][12][13][14]19,20 Previous studies have demonstrated that the use of additional lateral cores to the original sextant biopsy cores increased the detection rate of prostate cancer. Eskew et al 19 reported the usefulness of 13-18-core biopsies using the five-region anatomical approach.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9][10][11][12][13][14] Even in internally or externally validated nomograms, the feasibility of logistic regressionbased nomograms in actual individual urological clinics should be evaluated from the viewpoints of the acceptability of clinical factors taken into account in the nomogram and homogeneity of biopsy schemes between clinics and the institutions providing the nomograms. The life expectancy-and PV-adjusted biopsy may be unique, and could be difficult to adjust to any previously published nomogram.…”

Section: Introductionmentioning

confidence: 99%

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Development and external validation of a nomogram for predicting cancer probability at initial prostate biopsy using the life expectancy- and prostate volume-adjusted biopsy scheme

Nomura

Ito

Miyakubo

et al. 2011

Prostate Cancer Prostatic Dis

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BACKGROUND:We previously reported the diagnostic efficacy of the age-and prostate volume-adjusted prostate biopsy method (the adjusted biopsy method). Here, we developed a new nomogram for predicting cancer probability at initial biopsy using the adjusted method. METHODS:Between 2002 and 2010, 1059 Japanese men with PSA levels between 1.1 and 40 ng ml À1 and biopsied for the first time using the adjusted method at Gunma University Hospital were enrolled. All subjects underwent digital rectal examination (DRE) and transrectal ultrasonography (TRUS). Data from the initial 849 subjects were used for development of the nomogram and those from the final 210 subjects were used for internal validation. External validation was conducted using data from two affiliated hospitals where the same adjusted biopsy method was used. The nomogram was developed through logistic regression analysis, and predictive accuracy and performance characteristics were assessed using the area under the curve (AUC) of the receiver operating characteristics and calibration plots. Furthermore, we compared the predictive accuracy of the newly developed nomogram with the 'Prostate Risk Indicator' using the development data set, as well as the two external data sets. RESULTS:The AUC of the logistic regression-based nomogram was significantly higher than those of any single clinical parameter. External validation showed significant correlations with the present model. The AUC-receiver operating characteristic of the 'Prostate Risk Indicator' was the second largest following the new nomogram using the development data set and one external data set and almost equal to the new nomogram using the other external data set.CONCLUSIONS: Nevertheless the present model does not include somewhat subjective findings on TRUS abnormality, which is necessary for the estimation by 'Prostate Risk Indicator', the predictive accuracy of the present simple nomogram could be excellent enough to contribute to accurate shared decision-making between doctors and men who are candidates for the adjusted biopsy scheme.

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Development of a nomogram to predict probability of positive initial prostate biopsy among Japanese patients

Cited by 66 publications

References 19 publications

A nomogram based on age, prostate-specific antigen level, prostate volume and digital rectal examination for predicting risk of prostate cancer

A nomogram based on age, prostate-specific antigen level, prostate volume and digital rectal examination for predicting risk of prostate cancer

The prognostic significance of loss of the androgen receptor and neuroendocrine differentiation in prostate biopsy specimens among castration-resistant prostate cancer patients

Development and external validation of a nomogram for predicting cancer probability at initial prostate biopsy using the life expectancy- and prostate volume-adjusted biopsy scheme

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