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

Published

Journal Article

To 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.We 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).The 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.Identifying men at increased risk for having a biopsy detectable prostate cancer should consider multiple factors, including an estimate of prostate volume.

Full Text

Cited Authors

  • Roobol, MJ; Schröder, FH; Hugosson, J; Jones, JS; Kattan, MW; Klein, EA; Hamdy, F; Neal, D; Donovan, J; Parekh, DJ; Ankerst, D; Bartsch, G; Klocker, H; Horninger, W; Benchikh, A; Salama, G; Villers, A; Freedland, SJ; Moreira, DM; Vickers, AJ; Lilja, H; Steyerberg, EW

Published Date

  • April 2012

Published In

Volume / Issue

  • 30 / 2

Start / End Page

  • 149 - 155

PubMed ID

  • 22203238

Pubmed Central ID

  • 22203238

Electronic International Standard Serial Number (EISSN)

  • 1433-8726

International Standard Serial Number (ISSN)

  • 0724-4983

Digital Object Identifier (DOI)

  • 10.1007/s00345-011-0804-y

Language

  • eng