A Novel Nomogram to Predict the Probability of Prostate Cancer on Repeat Biopsy

Benecchi, Luigi; Pieri, Anna Maria; Melissari, M; Potenzoni, Michele; Pastizzaro, Carmelo Destro

doi:10.1016/j.juro.2008.03.043

Cited by 33 publications

(21 citation statements)

References 14 publications

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“…While there have been nomograms derived from these studies, they offer conflicting evidence on the role of PSA and its calculated kinetics (e.g. doubling time) in predicting prostate cancer in the repeat biopsy setting (Moussa et al 2010; Benecchi et al 2008). …”

Section: Discussionmentioning

confidence: 99%

Human kallikrein-2 gene and protein expression predicts prostate cancer at repeat biopsy

et al. 2014

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PurposeThe human kallikrein-2 (hK2) protein and two single nucleotide polymorphism (SNPs) (rs2664155, rs198977) of the gene are associated with prostate cancer risk. We examined whether hK2 protein and gene SNPs predict prostate cancer at the time of repeat biopsy.MethodsWe prospectively offered a repeat biopsy to men with a negative prostate biopsy performed for a PSA >4.0 ng/mL or abnormal Digital Rectal Exam (DRE) between 2001–2005. We genotyped and measured serum hK2 levels in 941 men who underwent a repeat prostate biopsy. Logistic regression analyses were conducted to determine the significance of KLK2 SNPs and hK2 levels for predicting cancer at repeat biopsy.ResultsOf the 941 patients, 180 (19.1%) were found to have cancer. The rs198977 SNP was positively associated with cancer at repeat biopsy (OR variant T allele = 1.8, 95% CI: 1.04-3.13, p = 0.049). When combined, the odds ratio for prostate cancer for patients with high hK2 levels and the variant T-allele of rs198977 was 3.77 (95% CI: 1.94-7.32, p < 0.0001), compared to patients with low hK2 levels and the C-allele. The addition of hK2 levels and KLK2 rs198977 to the baseline predictive model did not significantly increase the area under the curve from a baseline model of 0.67 to 0.69 (p = 0.6).ConclusionsThe KLK2 SNP rs198977 was positively associated with hK2 levels and predicts prostate cancer at the time of repeat prostate biopsy. Further characterization of the KLK2 gene will be needed to determine its clinical utility.

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Section: Discussionmentioning

confidence: 99%

Human kallikrein-2 gene and protein expression predicts prostate cancer at repeat biopsy

et al. 2014

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“…Furthermore, prospective trials have failed to demonstrate an association between the presence of HGPIN at initial PBx and subsequent PCa at repeat PBx [33,34,35]. Conversely, Benecchi et al [36], Rochester et al [37] and Netto and Epstein [38] have identified the presence of HGPIN as a risk factor in their analyses and included HGPIN in their novel repeat PBx nomograms.…”

Section: Resultsmentioning

confidence: 99%

Prostate Saturation Biopsy following a First Negative Biopsy: State of the Art

et al. 2012

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Introduction: Saturation prostate biopsy (SPBx) has been initially introduced to improve prostate cancer (PCa) detection rate (DR) in the repeat setting. Nevertheless, the optimal number and the most appropriate location of the cores, together with the timing to perform a second PBx and the eventual modification of the PBx protocols according to the different clinical situations, are matters of debate. The aim of this review is to perform a critical analysis of the literature about the actual role of SPBx in the repeat setting. Materials and Methods: We performed a systematic review of the literature since 1995 up to 2011. Electronic searches were limited to the English language, using the MEDLINE database. The key words ‘saturation prostate biopsy’ and ‘repeated prostate biopsy’ were used. Results: SPBx improves PCa DR if clinical suspicion persists after previous biopsy with negative findings and provides an accurate prediction of prostate tumor volume and grade, even if the issue about the number and locations of the cores is still a matter of debate. Conclusions: At present, SPBx seems to be really necessary in men with persistent suspicion of PCa after negative initial biopsy and probably in patients with a multifocal high-grade prostatic intraepithelial neoplasia or atypical small acinar proliferation. In the remaining situations, adopting an individualized scheme is preferable.

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“…The combined use of multiple predictive factors has been designed and nomograms for repeat biopsy were reported, including many weighted markers such as age, digital rectal examination, PSA, prostate volume, PSA density, PSA TZ density, F/T, family history and initial biopsy findings [10,11,34,35]. Using these nomograms, the accuracy of cancer detection was approximately 70-80%.…”

Section: Discussionmentioning

confidence: 99%

Management of Men with a Suspicion of Prostate Cancer after Negative Initial Prostate Biopsy Results

et al. 2014

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Introduction: For men with elevated prostate-specific antigen (PSA), appropriate management after negative prostate biopsy remains controversial. After determining PSA kinetics, subsequent follow-up was considered. Patients and Methods: A total of 115 cases with negative repeat biopsy were followed by evaluating PSA kinetics and ratio of percent free PSA (F/T) and by performing second repeat biopsy. Results: Eighteen cancer cases were diagnosed. Shorter PSA doubling times and faster velocities were found in cancer cases compared with cases without cancer. We observed a clear decrease in F/T among cancer cases. Conclusions: To avoid unnecessary repeat biopsies, cases with a suspicion of cancer after negative biopsy can be divided into two groups: one that requires additional biopsies and one with an average change in PSA of <1 ng/ml/year and no change in F/T, which is recommended for surveillance as stable disease without biopsy over a specified time period.

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A Novel Nomogram to Predict the Probability of Prostate Cancer on Repeat Biopsy

Cited by 33 publications

References 14 publications

Human kallikrein-2 gene and protein expression predicts prostate cancer at repeat biopsy

Human kallikrein-2 gene and protein expression predicts prostate cancer at repeat biopsy

Prostate Saturation Biopsy following a First Negative Biopsy: State of the Art

Management of Men with a Suspicion of Prostate Cancer after Negative Initial Prostate Biopsy Results

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