In:
BJU International, Wiley, Vol. 118, No. 5 ( 2016-11), p. 706-713
Kurzfassung:
To analyse the performance of the Prostate Cancer Prevention Trial Risk Calculator ( PCPT ‐ RC ) and two iterations of the European Randomised Study of Screening for Prostate Cancer ( ERSPC ) Risk Calculator, one of which incorporates prostate volume ( ERSPC ‐ RC ) and the other of which incorporates prostate volume and the prostate health index ( PHI ) in a referral population ( ERSPC ‐ PHI ). Patients and Methods The risk of prostate cancer ( PC a) and significant PC a (Gleason score ≥7) in 2001 patients from six tertiary referral centres was calculated according to the PCPT ‐ RC and ERSPC ‐ RC formulae. The calculators’ predictions were analysed using the area under the receiver‐operating characteristic curve ( AUC ), calibration plots, Hosmer–Lemeshow test for goodness of fit and decision‐curve analysis. In a subset of 222 patients for whom the PHI score was available, each patient's risk was calculated as per the ERSPC ‐ RC and ERSPC ‐ PHI risk calculators. Results The ERSPC ‐ RC outperformed the PCPT ‐ RC in the prediction of PC a, with an AUC of 0.71 compared with 0.64, and also outperformed the PCPT ‐ RC in the prediction of significant PC a ( P 〈 0.001), with an AUC of 0.74 compared with 0.69. The ERSPC ‐ RC was found to have improved calibration in this cohort and was associated with a greater net benefit on decision‐curve analysis for both PC a and significant PC a. The performance of the ERSPC ‐ RC was further improved through the addition of the PHI score in a subset of 222 patients. The AUC s of the ERSPC ‐ PHI were 0.76 and 0.78 for PC a and significant PC a prediction, respectively, in comparison with AUC values of 0.72 in the prediction of both PC a and significant PC a for the ERSPC ‐ RC ( P = 0.12 and P = 0.04, respectively). The ERSPC ‐ PHI risk calculator was well calibrated in this cohort and had an increase in net benefit over that of the ERSPC ‐ RC . Conclusions The performance of the risk calculators in the present cohort shows that the ERSPC ‐ RC is a superior tool in the prediction of PC a; however the performance of the ERSPC ‐ RC in this population does not yet warrant its use in clinical practice. The incorporation of the PHI score into the ERSPC ‐ PHI risk calculator allowed each patient's risk to be more accurately quantified. Individual patient risk calculation using the ERSPC ‐ PHI risk calculator can be undertaken in order to allow a systematic approach to patient risk stratification and to aid in the diagnosis of PC a.
Materialart:
Online-Ressource
ISSN:
1464-4096
,
1464-410X
DOI:
10.1111/bju.2016.118.issue-5
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2016
ZDB Id:
2019983-1
