Validation of a Nomogram for Predicting Positive Repeat Biopsy for Prostate Cancer

Yanke, Brent V.; Gönen, Mithat; Scardino, Peter T.; Kattan, Michael W.

doi:10.1097/01.ju.0000150522.82760.00

Cited by 76 publications

(47 citation statements)

References 16 publications

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“…The high specificity of these markers may aid in refining current algorithms for risk assessment in prostate cancer (25)(26)(27). For example, cancer prevalence in the population of patients having PSA Ͻ4 g/L when both cohorts were combined (n ϭ 70) was 44%.…”

Section: Discussionmentioning

confidence: 99%

Development of a Multiplexed Urine Assay for Prostate Cancer Diagnosis

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Development of a Multiplexed Urine Assay for Prostate Cancer Diagnosis

et al. 2008

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“…It is been suggested that a nomogram validated by Yanke et al be used when deciding on a repeat biopsy (18). In this nomogram, parameters such as age, family history, PSA, PSA velocity, rectal exam findings, time elapsed following the initial biopsy procedure, the cumulative negative foci number, the presence of a diagnosis of HGPIN/ASAP in previous biopsies are used as risk factors (18). Nowadays, however, there is consensus about the performance of a repeat biopsy in cases where ASAP is detected.…”

Section: Discussionmentioning

confidence: 99%

How many cores should be taken in a repeat biopsy on patients in whom atypical small acinar proliferation has been identified in an initial transrectal prostate biopsy?

Aglamis

Kocaarslan

Yücetaş³

et al. 2014

Int. braz j urol.

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ARTICLE INfO ______________________________________________________________ ______________________Objective: To compare cancer detection rates according to the number of biopsy cores in patients on whom a repeat prostate biopsy was performed for atypical small acinar proliferation (ASAP). Materials and Methods:The data of 4950 consecutive patients on whom prostate biopsies were performed were assessed retrospectively. A total of 107 patients were identified as having ASAP following an initial prostate biopsy, and they were included in the study. A six-core prostate biopsy (PBx) was performed on 15 of the 107 patients, 12 PBx on 32 patients, and 20 PBx on 60 patients. Cancer detection rates were compared according to the number of biopsy cores. The localization of the cancer foci was also evaluated.Results: The cancer detection rates in patients on whom 6 PBx, 12 PBx, and 20 PBx were performed were 20% (3/15), 31% (10/32), and 58% (35/60), respectively, and a statistically significant difference was found (p = 0.005). When cancer detection rates in patients with total prostate specific antigen (PSA) < 10ng/mL, PSA density ≥ 0.15, normal digital rectal examination, and prostate volume ≥ 55mL were compared according to the number of biopsy cores, a significant difference was identified (p = 0.02, 0.03, 0.006, and 0.04, respectively). Seventy-five percent of the foci where cancer was detected were at the same and/or adjacent sites as the ASAP foci in the initial biopsy, and 54% were identified in contralateral biopsies in which ASAP foci were present. Conclusion: As the biopsy core number increases, the cancer detection rate increases significantly in patients on whom a repeat biopsy is performed due to ASAP. The highest cancer rate is found in 20-core repeat biopsies performed equally from all foci.

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“…Tres trabajos estudian pacientes con biopsias previas negativas [7][8][9] . El resto analizan la probabilidad de una biopsia prostática positiva para tumor.…”

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Validación prospectiva de un nomograma predictivo de la presencia de cáncer de próstata en pacientes que se someten a biopsia transrectal ecodirigida de 10 cilindros

et al. 2010

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R E S U M E NIntroducción: la biopsia prostática transrectal ecodirigida es, hasta la fecha, la prueba ineludible en el diagnóstico del cáncer de próstata. Numerosas variables se han asociado de manera univariante y multivariante a la presencia de cáncer en la biopsia (tacto rectal [TR], antígeno prostático específico (PSA) sérico, fracción libre del PSA [PSAl/PSAt], etc.). Actualmente están en boga modelos matemáticos multivariantes que integran estas variables y que mejoran la capacidad predictiva del resultado de la prueba.Objetivo: desarrollar un modelo matemático particular que estime la probabilidad de los pacientes, a quienes se indique una biopsia de próstata, de que esta sea positiva. Del mismo modo aplicarlo a pacientes ulteriores y evaluar su capacidad predictiva.Material y método: incluimos 410 pacientes biopsiados de manera consecutiva por sospecha en el TR o por dos PSA séricos mayores de 4 ng/ml. La biopsia prostática se realizaba con toma de 10 cilindros. Se excluyeron los pacientes con PSA > 20 y aquellos con biopsias previas. Las variables registradas en cada paciente eran: edad, PSA total-fracción libre de PSA, volumen prostático, volumen de la zona transicional, densidad del PSA, densidad del PSA respecto de la zona transicional, TR, presencia de hallazgos sugestivos de cáncer durante la ecografía transrectal (nódulos hipoecoicos). La validación externa prospectiva se llevó a cabo con 185 pacientes con idénticos criterios de inclusión.El análisis estadístico consta de cuatro fases: un estudio univariante, uno multivariante por regresión logística mediante el cual se desarrolla el nomograma, una validación interna y una validación externa prospectiva. Se utilizaron los programas S-Plus ® y SPSS 12.0 ® para el desarrollo matemático.Resultados: las variables que, en el modelo multivariante, se asociaban de manera independiente y significativa a la presencia de cáncer fueron: la edad, el TR, el volumen de la zona transicional, el PSA-densidad y la presencia de nódulos hipoecoicos durante la ecografía transrectal. Con dichas variables se desarrolló un modelo matemático gráfico, nomogra- ACTAS UROLÓGICAS ESPAÑOLAS IntroducciónLa biopsia prostática transrectal ecodirigida es, hasta la fecha, la prueba ineludible en el diagnóstico del cáncer de próstata. Es una técnica segura no exenta de leves complicaciones, sobre todo en la época en la que las biopsias ampliadas son la norma. Es deber del clínico indicarla a aquellos pacientes que se van a beneficiar de un potencial diagnóstico de cáncer prostático.En este grupo de pacientes el urólogo, de una manera más o menos activa, deberá buscar la presencia de este tumor en sus estadios precoces, donde en la mayoría de los casos su curso es indolente. Para ello disponemos de varias herramientas fundamentales: tacto rectal (TR), antígeno prostático específico (PSA) sérico, fracción libre del PSA (PSAl/PSAt), etc. Así se han desarrollado numerosas variables derivadas de las anteriores que, de manera independiente, se han asociado a la presencia de biopsias pr...

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Validation of a Nomogram for Predicting Positive Repeat Biopsy for Prostate Cancer

Cited by 76 publications

References 16 publications

Development of a Multiplexed Urine Assay for Prostate Cancer Diagnosis

Development of a Multiplexed Urine Assay for Prostate Cancer Diagnosis

How many cores should be taken in a repeat biopsy on patients in whom atypical small acinar proliferation has been identified in an initial transrectal prostate biopsy?

Validación prospectiva de un nomograma predictivo de la presencia de cáncer de próstata en pacientes que se someten a biopsia transrectal ecodirigida de 10 cilindros

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