Development of Improved Nomogram for Prediction of Outcome of Initial Prostate Biopsy Using Readily Available Clinical Information

Zaytoun, Osama; Kattan, Michael W.; Moussa, Ayman S.; Li, Jianbo; Yu, Changhong; Jones, J. Stephen

doi:10.1016/j.urology.2011.04.042

Cited by 43 publications

(35 citation statements)

References 31 publications

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“…Eastham et al (19) devised a model after studying group of 700 patients whose PSA values were less than 4 ng/mL. Other studies had investigated the prostate cancer with higher than 10 ng/mL (20-22). Among Patients with a PSA value greater than 10 ng/mL, 36%-76% of them were diagnosed with PCA by prostate biopsy.…”

Section: Discussionmentioning

confidence: 99%

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Nomogram for Prediction of Prostate Cancer with Serum Prostate Specific Antigen Less than 10 ng/mL

et al. 2014

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Although prostate-specific antigen (PSA) is a very useful screening tool, prostate biopsy is still necessary to confirm prostate cancer (PCA). However, it is reported that PSA is associated with a high false-positive rate and prostate biopsy also has various procedure-related complications. Therefore, the authors have devised a nomogram, which can be used to estimate the risk of PCA, using available clinical data for men with a serum PSA less than 10 ng/mL. Prostate biopsies were obtained from 2,139 patients from January 1998 to March 2011. Of them, 1,171 patients with a serum PSA less than 10 ng/mL were only included in this study. Patient age, PSA, free PSA, prostate volume, PSA density and percent free PSA ratio were analyzed. Among 1,171 patients, 255 patients (21.8%) were diagnosed as PCA. Multivariate analyses showed that patient age, prostate volume, PSA and percent free PSA had statistically significant relationships with PCA (P < 0.05) and were used as nomogram predictor variables. The area under the (ROC) curve for all factors in a model predicting PCA was 0.759 (95% CI, 0.716-0.803).Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

“…In some studies, multiple values were used as a predictor of PCA, such as age, PSA, percent free PSA, family history of PCA, abnormal DRE findings and races (18-22). In some ways, DRE is a different result between individuals, so we excluded the DRE results as a predictor of PCA.…”

Section: Discussionmentioning

confidence: 99%

Nomogram for Prediction of Prostate Cancer with Serum Prostate Specific Antigen Less than 10 ng/mL

et al. 2014

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“…The indications to perform an initial biopsy were PSA <10 ng/ml and/or fPSA% <0.1 plus abnormal DRE and/or TRUS ﬁndings or PSA >10 ng/ml regardless of DRE and TRUS status [6,16]. …”

Section: Methodsmentioning

confidence: 99%

Investigation of Optimal Prostate Biopsy Schemes for Chinese Patients with Different Clinical Characteristics

Chen¹,

Luo²,

Zhang³

et al. 2012

Urol Int

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Purpose: To investigate the optimal schemes of prostate biopsy according to prostate volume (PV), age and transrectal ultrasound (TRUS) status in Chinese men. Methods: 923 consecutive patients who underwent initial TRUS-guided systematic 12-core prostate biopsy (12PBx) were enrolled in this study. The 12PBx was obtained by overlapping of conventional sextant, lateral base, mid-gland of peripheral zone and apex. Each sample was individually marked and inked before fixation. Patients were divided into 8 subgroups on the basis of independent risk factors investigated using logistic regression model. Subsequently, 12PBx was defined as self-control for the analysis of biopsy schemes (6-, 8- and 10PBx) on individual core basis. The prostate cancer detection rates (CDRs) of 6-, 8-, 10- and 12PBx were compared for each individual subgroup. Results: The 12PBx detected 253 (27.4%) cases of prostate cancer (PCa), of which 67.2, 47.1 and 61.3% were located in the base, mid-gland and apex, respectively. Multivariate analysis indicated that age, TRUS status and PV were independent risk factors for PCa detection. CDR increased with increasing biopsy cores. However, for patients with age ≥65 years, positive TRUS and PV <38.5 cm³, CDR of 8PBx (30.6%) was similar to 10PBx (32.2%) and 12PBx (32.2%); for patients with age ≥65 years, negative TRUS and PV <38.5 cm³ or ones with age ≥65 years, positive TRUS and PV ≥38.5 cm³, 10PBx was as effective as 12PBx in detecting PCa (27.8, 27.5 vs. 28.9, 29.3%, respectively). Conclusion: Age, TRUS status and PV were independent risk factors for PCa detection. Traditional sextant biopsy is not recommended. 8-, 10-, or 12PBx as an individual biopsy scheme might be adopted according to these risk factors for Chinese patients.

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“…In the vast majority of cases, prostate cancer is diagnosed by a prostate biopsy (PBx) performed because of an elevated PSA level and/or an abnormal digital rectal examination (DRE). In current clinical practice, however, the diagnostic yield of a first extended PBx is in the range of 40% (2) even selecting patients by "improved" nomograms (3).…”

Section: Introductionmentioning

confidence: 99%

Pentraxin 3: A Novel Biomarker for Predicting Progression from Prostatic Inflammation to Prostate Cancer

et al. 2014

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Pentraxin-3 (PTX3) is a member of the pentraxin family of innate immune regulators, which includes C-reactive protein (CRP). PTX3 has been implicated in angiogenesis, proliferation, and immune escape in cancer. In the present study, we evaluated PTX3 tissue expression and serum concentration as a biomarker to discriminate prostatic inflammation and benign prostatic hyperplasia (BPH) from prostate cancer, and to determine whether PTX3 status may predict progression from BPH to prostate cancer. We analyzed 40 patients with biopsy-proven BPH who underwent a second prostate biopsy 12 to 36 months later when they were diagnosed with prostate cancer or inflammation/BPH (n ¼ 20 patients each group). Furthermore, we evaluated PTX3 serum concentrations in an independent set of patients with biopsy-proven inflammation/BPH (n ¼ 61) and prostate cancer (n ¼ 56). We found reduced PTX3 tissue expression in patients with prostatic inflammation/BPH compared with patients who developed prostate cancer. In the latter group, there was an increase in PTX3 tissue expression between the first and second prostate biopsy. PTX3 serum levels were also higher in patients with prostate cancer than in patients with inflammation/BPH. In contrast, there was no difference in serum PSA or CRP levels in these two groups. ROC curve analysis confirmed the reliability of PTX3 serum levels in predicting prostate cancer development, identifying a cutoff value of 3.25 ng/mL with a sensitivity and a specificity of 89.3% and 88.5%, respectively. In summary, our results encourage further evaluation of PTX3 as a tissue biopsy and blood-borne biomarker to discriminate BPH from prostate cancer. Cancer Res; 74(16); 4230-8. Ó2014 AACR.

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Development of Improved Nomogram for Prediction of Outcome of Initial Prostate Biopsy Using Readily Available Clinical Information

Cited by 43 publications

References 31 publications

Nomogram for Prediction of Prostate Cancer with Serum Prostate Specific Antigen Less than 10 ng/mL

Nomogram for Prediction of Prostate Cancer with Serum Prostate Specific Antigen Less than 10 ng/mL

Investigation of Optimal Prostate Biopsy Schemes for Chinese Patients with Different Clinical Characteristics

Pentraxin 3: A Novel Biomarker for Predicting Progression from Prostatic Inflammation to Prostate Cancer

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