BACKGROUND: To assess the added value of biopsy factors, like maximum cancer length in a core (MCL), cumulative cancer length (CCL), cumulative length of positive cores (CLPC), percentage of cancer involvement in positive cores (CIPC) and the Prostate Cancer Research International: Active Surveillance (PRIAS) criteria in patients who underwent radical prostatectomy (RP) but eligible for active surveillance (AS). METHODS: From January 2002 to December 2007, 750 consecutive subjects underwent RP. We identified 147 (19.07%) patients who were eligible for AS based on PRIAS criteria: clinical stage T1c or T2, PSA level of ⩽ 10 ng ml(-1), Gleason score ⩽ 6, PSA-D of <0.2 ng ml(-2) and one or two positive biopsy cores. We calculated the diagnostic accuracy of biopsy factors in determining pathological confirmed unfavorable disease. Decision curve analysis (DCA) were performed. RESULTS: Of all subjects, 95 patients (66.43%) had favorable whereas 48 had (33.57%) unfavorable disease. On multivariate analyses, the inclusion of MCL, CCL, CLPC and CIPC significantly increased the accuracy of the base multivariate model in predicting unfavorable disease. The gain in predictive accuracy for MCL in a core, CCL, CLPC and CIPC ranged from 13 to 27%. The DCA shows that adding MCL, CCL, CLPC and CIPC resulted in a greater net benefit when the probability of ranges between 15 and 50%. The models can be applied at the cost of missing not more than 16.83% of unfavorable disease. CONCLUSIONS: Our findings suggested that the addition of these biopsy factors to PRIAS criteria has the potential to significantly increase the ability to detect unfavorable disease.
BACKGROUND: To assess the added value of biopsy factors, like maximum cancer length in a core (MCL), cumulative cancer length (CCL), cumulative length of positive cores (CLPC), percentage of cancer involvement in positive cores (CIPC) and the Prostate Cancer Research International: Active Surveillance (PRIAS) criteria in patients who underwent radical prostatectomy (RP) but eligible for active surveillance (AS). METHODS: From January 2002 to December 2007, 750 consecutive subjects underwent RP. We identified 147 (19.07%) patients who were eligible for AS based on PRIAS criteria: clinical stage T1c or T2, PSA level of ⩽ 10 ng ml(-1), Gleason score ⩽ 6, PSA-D of <0.2 ng ml(-2) and one or two positive biopsy cores. We calculated the diagnostic accuracy of biopsy factors in determining pathological confirmed unfavorable disease. Decision curve analysis (DCA) were performed. RESULTS: Of all subjects, 95 patients (66.43%) had favorable whereas 48 had (33.57%) unfavorable disease. On multivariate analyses, the inclusion of MCL, CCL, CLPC and CIPC significantly increased the accuracy of the base multivariate model in predicting unfavorable disease. The gain in predictive accuracy for MCL in a core, CCL, CLPC and CIPC ranged from 13 to 27%. The DCA shows that adding MCL, CCL, CLPC and CIPC resulted in a greater net benefit when the probability of ranges between 15 and 50%. The models can be applied at the cost of missing not more than 16.83% of unfavorable disease. CONCLUSIONS: Our findings suggested that the addition of these biopsy factors to PRIAS criteria has the potential to significantly increase the ability to detect unfavorable disease.
Authors: Albert El Hajj; Guillaume Ploussard; Alexandre de la Taille; Yves Allory; Dimitri Vordos; Andras Hoznek; Claude Clément Abbou; Laurent Salomon Journal: BJU Int Date: 2012-06-21 Impact factor: 5.588
Authors: L M Wong; D E Neal; A Finelli; S Davis; C Bonner; J Kapoor; J Trachtenberg; B Thomas; C M Hovens; A J Costello; N M Corcoran Journal: Prostate Cancer Prostatic Dis Date: 2015-02-10 Impact factor: 5.554
Authors: Caroline M Moore; Nicola L Robertson; Nasr Arsanious; Thomas Middleton; Arnauld Villers; Laurence Klotz; Samir S Taneja; Mark Emberton Journal: Eur Urol Date: 2012-06-13 Impact factor: 20.096
Authors: Fritz H Schröder; Jonas Hugosson; Monique J Roobol; Teuvo L J Tammela; Stefano Ciatto; Vera Nelen; Maciej Kwiatkowski; Marcos Lujan; Hans Lilja; Marco Zappa; Louis J Denis; Franz Recker; Alvaro Páez; Liisa Määttänen; Chris H Bangma; Gunnar Aus; Sigrid Carlsson; Arnauld Villers; Xavier Rebillard; Theodorus van der Kwast; Paula M Kujala; Bert G Blijenberg; Ulf-Hakan Stenman; Andreas Huber; Kimmo Taari; Matti Hakama; Sue M Moss; Harry J de Koning; Anssi Auvinen Journal: N Engl J Med Date: 2012-03-15 Impact factor: 91.245
Authors: Mark Louie-Johnsun; Mischel Neill; Karien Treurnicht; Michael Jarmulowicz; Christopher Eden Journal: BJU Int Date: 2009-05-07 Impact factor: 5.588