Importance of prostate volume in the European Randomised Study of Screening for Prostate Cancer (ERSPC) risk calculators: results from the prostate biopsy collaborative group

Abstract

ObjectivesTo compare the predictive performance and potential clinical usefulness of risk calculators of the European Randomized Study of Screening for Prostate Cancer (ERSPC RC) with and without information on prostate volume.MethodsWe studied 6 cohorts (5 European and 1 US) with a total of 15,300 men, all biopsied and with pre-biopsy TRUS measurements of prostate volume. Volume was categorized into 3 categories (25, 40, and 60 cc), to reflect use of digital rectal examination (DRE) for volume assessment. Risks of prostate cancer were calculated according to a ERSPC DRE-based RC (including PSA, DRE, prior biopsy, and prostate volume) and a PSA + DRE model (including PSA, DRE, and prior biopsy). Missing data on prostate volume were completed by single imputation. Risk predictions were evaluated with respect to calibration (graphically), discrimination (AUC curve), and clinical usefulness (net benefit, graphically assessed in decision curves).ResultsThe AUCs of the ERSPC DRE-based RC ranged from 0.61 to 0.77 and were substantially larger than the AUCs of a model based on only PSA + DRE (ranging from 0.56 to 0.72) in each of the 6 cohorts. The ERSPC DRE-based RC provided net benefit over performing a prostate biopsy on the basis of PSA and DRE outcome in five of the six cohorts.ConclusionsIdentifying men at increased risk for having a biopsy detectable prostate cancer should consider multiple factors, including an estimate of prostate volume.

Prostate Volume Index and Chronic Inflammation of the Prostate Type IV with Respect to the Risk of Prostate Cancer

“…PV is an important parameter for detecting PCA, as reported by reviews of the literature which showed that smaller PV sizes are associated with PCA [9,10]. In the current study, PV, as indicated by the negative Pearson correlation coefficient, was also a negative independent predictor of PCA (data not shown).…”

Prostate Volume Index Associates with a Decreased Risk of Prostate Cancer: Results of a Large Cohort of Patients Elected to a First Biopsy Set

“…The incidence of PCA increases with age and PSA levels [10][11][12] ; moreover, the risk of detecting PCA is inversely related to PV [4][5][6][7] . This study has shown that the detection rate of PCA was quite high (49%) in a large population of patients who were elected to a first set of biopsies, which were all performed in standard conditions including 14 cores and excluding additional cores related to DRE or imaging abnormal findings.…”

“…Clinical investigations have shown that while PCA risk is increased by age, prostate specific antigen (PSA) serum levels, and abnormal digital rectal exam (DRE), it is decreased by prostate volume (PV) [4][5][6][7] .…”

Development and external multicenter validation of Chinese Prostate Cancer Consortium prostate cancer risk calculator for initial prostate biopsy

“…Secondly, the original ERSPC-RC and PCPT-RC did not include information of prostate volume (PV) or free PSA ratio. However, researchers found that adding PV estimated by DRE into the ERSPC-RC [12] and adding transrectal ultrasound (TRUS)-measured PV into the PCPT-RC [13] would improve diagnostic accuracy. In the current clinical practice, there are more patients who have undergone TRUS before biopsy.…”