A Clinically Significant Prostate Cancer Predictive Model Using Digital Rectal Examination Prostate Volume Category to Stratify Initial Prostate Cancer Suspicion and Reduce Magnetic Resonance Imaging Demand
A predictive model including age, PCa family history, biopsy status (initial vs repeat), DRE (normal vs abnormal), serum prostate-specific antigen (PSA), and DRE prostate volume ca-tegory was developed to stratify initial PCa suspicion in 1486 men with PSA > 3 ng/mL and/or abnormal DRE, in whom m...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/20/5100 |
| _version_ | 1797474525827301376 |
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| author | Juan Morote Ángel Borque-Fernando Marina Triquell Miriam Campistol Anna Celma Lucas Regis José M. Abascal Pol Servian Jacques Planas Olga Mendez Luis M. Esteban Enrique Trilla |
| author_facet | Juan Morote Ángel Borque-Fernando Marina Triquell Miriam Campistol Anna Celma Lucas Regis José M. Abascal Pol Servian Jacques Planas Olga Mendez Luis M. Esteban Enrique Trilla |
| author_sort | Juan Morote |
| collection | DOAJ |
| description | A predictive model including age, PCa family history, biopsy status (initial vs repeat), DRE (normal vs abnormal), serum prostate-specific antigen (PSA), and DRE prostate volume ca-tegory was developed to stratify initial PCa suspicion in 1486 men with PSA > 3 ng/mL and/or abnormal DRE, in whom mpMRI followed; 2- to 4-core TRUS-guided biopsies where Prostate Imaging Report and Data System (PI-RADS) > 3 lesions and/or 12-core TRUS systematic biopsies were performed in one academic institution between 1 January 2016–31 December 2019. The csPCa detection rate, defined as International Society of Uro-Pathology grade group 2 or higher, was 36.9%. An external validation of designed BCN-RC 1 was carried out on 946 men from two other institutions in the same metropolitan area, using the same criteria of PCa suspicion and diagnostic approach, yielded a csPCa detection rate of 40.8%. The areas under the receiver operating characteristic curves of BCN-RC 1 were 0.823 (95% CI: 0.800–0.846) in the development cohort and 0.837 (95% CI: 0.811–0.863) in the validation cohort (<i>p</i> = 0.447). In both cohorts, BCN-RC 1 exhibited net benefit over performing mpMRI in all men from 8 and 12% risk thresholds, respectively. At 0.95 sensitivity of csPCa, the specificities of BCN-RC 1 were 0.24 (95% CI: 0.22–0.26) in the development cohort and 0.34 (95% CI: 0.31–0.37) in the validation cohort (<i>p</i> < 0.001). The percentages of avoided mpMRI scans were 17.2% in the development cohort and 22.3% in the validation cohort, missing between 1.8% and 2% of csPCa among men at risk of PCa. In summary, BCN-RC 1 can stratify initial PCa suspicion, reducing the demand of mpMRI, with an acceptable loss of csPCa. |
| first_indexed | 2024-03-09T20:31:21Z |
| format | Article |
| id | doaj.art-ad8312ba5e6147339c7ca721d1945ca8 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T20:31:21Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-ad8312ba5e6147339c7ca721d1945ca82023-11-23T23:21:57ZengMDPI AGCancers2072-66942022-10-011420510010.3390/cancers14205100A Clinically Significant Prostate Cancer Predictive Model Using Digital Rectal Examination Prostate Volume Category to Stratify Initial Prostate Cancer Suspicion and Reduce Magnetic Resonance Imaging DemandJuan Morote0Ángel Borque-Fernando1Marina Triquell2Miriam Campistol3Anna Celma4Lucas Regis5José M. Abascal6Pol Servian7Jacques Planas8Olga Mendez9Luis M. Esteban10Enrique Trilla11Department of Urology and Surgery, Vall d’Hebron Hospital and Universitat Autònoma de Barcelona, 08035 Barcelona, SpainDepartment of Urology, Hospital Miguel Servet, IIS-Aragon, 50009 Zaragoza, SpainDepartment of Urology and Surgery, Vall d’Hebron Hospital and Universitat Autònoma de Barcelona, 08035 Barcelona, SpainDepartment of Urology and Surgery, Vall d’Hebron Hospital and Universitat Autònoma de Barcelona, 08035 Barcelona, SpainDepartment of Urology and Surgery, Vall d’Hebron Hospital and Universitat Autònoma de Barcelona, 08035 Barcelona, SpainDepartment of Urology and Surgery, Vall d’Hebron Hospital and Universitat Autònoma de Barcelona, 08035 Barcelona, SpainDepartments of Urology and Surgery, Parc de Salut Mar and Universitat Pompeu Fabra, 08003 Barcelona, SpainDepartment of Urology, Hospital Germans Trias I Pujol, 08916 Badalona, SpainDepartment of Urology and Surgery, Vall d’Hebron Hospital and Universitat Autònoma de Barcelona, 08035 Barcelona, SpainUrology Biomedical Research Unit, Vall d´Hebron Research Institute, 08035 Barcelona, SpainDepartment of Applied Mathematics, Escuela Universitaria Politécnica La Almunia, Universidad de Zaragoza, 50100 Zaragoza, SpainDepartment of Urology and Surgery, Vall d’Hebron Hospital and Universitat Autònoma de Barcelona, 08035 Barcelona, SpainA predictive model including age, PCa family history, biopsy status (initial vs repeat), DRE (normal vs abnormal), serum prostate-specific antigen (PSA), and DRE prostate volume ca-tegory was developed to stratify initial PCa suspicion in 1486 men with PSA > 3 ng/mL and/or abnormal DRE, in whom mpMRI followed; 2- to 4-core TRUS-guided biopsies where Prostate Imaging Report and Data System (PI-RADS) > 3 lesions and/or 12-core TRUS systematic biopsies were performed in one academic institution between 1 January 2016–31 December 2019. The csPCa detection rate, defined as International Society of Uro-Pathology grade group 2 or higher, was 36.9%. An external validation of designed BCN-RC 1 was carried out on 946 men from two other institutions in the same metropolitan area, using the same criteria of PCa suspicion and diagnostic approach, yielded a csPCa detection rate of 40.8%. The areas under the receiver operating characteristic curves of BCN-RC 1 were 0.823 (95% CI: 0.800–0.846) in the development cohort and 0.837 (95% CI: 0.811–0.863) in the validation cohort (<i>p</i> = 0.447). In both cohorts, BCN-RC 1 exhibited net benefit over performing mpMRI in all men from 8 and 12% risk thresholds, respectively. At 0.95 sensitivity of csPCa, the specificities of BCN-RC 1 were 0.24 (95% CI: 0.22–0.26) in the development cohort and 0.34 (95% CI: 0.31–0.37) in the validation cohort (<i>p</i> < 0.001). The percentages of avoided mpMRI scans were 17.2% in the development cohort and 22.3% in the validation cohort, missing between 1.8% and 2% of csPCa among men at risk of PCa. In summary, BCN-RC 1 can stratify initial PCa suspicion, reducing the demand of mpMRI, with an acceptable loss of csPCa.https://www.mdpi.com/2072-6694/14/20/5100prostate cancersuspicionclinically significantpredictive modelrisk calculatorexternal validation |
| spellingShingle | Juan Morote Ángel Borque-Fernando Marina Triquell Miriam Campistol Anna Celma Lucas Regis José M. Abascal Pol Servian Jacques Planas Olga Mendez Luis M. Esteban Enrique Trilla A Clinically Significant Prostate Cancer Predictive Model Using Digital Rectal Examination Prostate Volume Category to Stratify Initial Prostate Cancer Suspicion and Reduce Magnetic Resonance Imaging Demand Cancers prostate cancer suspicion clinically significant predictive model risk calculator external validation |
| title | A Clinically Significant Prostate Cancer Predictive Model Using Digital Rectal Examination Prostate Volume Category to Stratify Initial Prostate Cancer Suspicion and Reduce Magnetic Resonance Imaging Demand |
| title_full | A Clinically Significant Prostate Cancer Predictive Model Using Digital Rectal Examination Prostate Volume Category to Stratify Initial Prostate Cancer Suspicion and Reduce Magnetic Resonance Imaging Demand |
| title_fullStr | A Clinically Significant Prostate Cancer Predictive Model Using Digital Rectal Examination Prostate Volume Category to Stratify Initial Prostate Cancer Suspicion and Reduce Magnetic Resonance Imaging Demand |
| title_full_unstemmed | A Clinically Significant Prostate Cancer Predictive Model Using Digital Rectal Examination Prostate Volume Category to Stratify Initial Prostate Cancer Suspicion and Reduce Magnetic Resonance Imaging Demand |
| title_short | A Clinically Significant Prostate Cancer Predictive Model Using Digital Rectal Examination Prostate Volume Category to Stratify Initial Prostate Cancer Suspicion and Reduce Magnetic Resonance Imaging Demand |
| title_sort | clinically significant prostate cancer predictive model using digital rectal examination prostate volume category to stratify initial prostate cancer suspicion and reduce magnetic resonance imaging demand |
| topic | prostate cancer suspicion clinically significant predictive model risk calculator external validation |
| url | https://www.mdpi.com/2072-6694/14/20/5100 |
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