OBJECTIVE: To create a nomogram for men on active surveillance (AS) for prediction of grade re-classification (GR) above Gleason score 6 (Grade group >2) at surveillance biopsy. PATIENTS AND METHODS: From a cohort of men enrolled in an AS programme, a multivariable model was used to identify clinical and pathological parameters predictive of GR. Nomogram performance was assessed using receiver operating characteristic curves, calibration, and decision curve analysis. RESULTS: Of 1 374 men, 254 (18.50%) were re-classified to Gleason ≥7 on surveillance prostate biopsy. Variables predictive of GR were earlier year of diagnosis [≤2004 vs ≥2005; odds ratio (OR) 2.16, P < 0.001], older age (OR 1.05, P < 0.001), higher prostate-specific antigen density [OR 1.19 (per 0.1 unit increase), P = 0.04], bilateral disease (OR 2.86, P < 0.001), risk strata (low-risk vs very-low-risk, OR 1.79, P < 0.001), and total number of biopsies without GR (OR 0.68, P < 0.001). On internal validation, a nomogram created using the multivariable model had an area under the curve of 0.757 (95% confidence interval 0.730-0.797) for predicting GR at the time of next surveillance biopsy. CONCLUSION: The nomogram described is currently being used at each return visit to assess the need for a surveillance biopsy, and could increase retention in AS.
OBJECTIVE: To create a nomogram for men on active surveillance (AS) for prediction of grade re-classification (GR) above Gleason score 6 (Grade group >2) at surveillance biopsy. PATIENTS AND METHODS: From a cohort of men enrolled in an AS programme, a multivariable model was used to identify clinical and pathological parameters predictive of GR. Nomogram performance was assessed using receiver operating characteristic curves, calibration, and decision curve analysis. RESULTS: Of 1 374 men, 254 (18.50%) were re-classified to Gleason ≥7 on surveillance prostate biopsy. Variables predictive of GR were earlier year of diagnosis [≤2004 vs ≥2005; odds ratio (OR) 2.16, P < 0.001], older age (OR 1.05, P < 0.001), higher prostate-specific antigen density [OR 1.19 (per 0.1 unit increase), P = 0.04], bilateral disease (OR 2.86, P < 0.001), risk strata (low-risk vs very-low-risk, OR 1.79, P < 0.001), and total number of biopsies without GR (OR 0.68, P < 0.001). On internal validation, a nomogram created using the multivariable model had an area under the curve of 0.757 (95% confidence interval 0.730-0.797) for predicting GR at the time of next surveillance biopsy. CONCLUSION: The nomogram described is currently being used at each return visit to assess the need for a surveillance biopsy, and could increase retention in AS.
Authors: Edward Chang; Tonye A Jones; Shyam Natarajan; Devi Sharma; Demetrios Simopoulos; Daniel J Margolis; Jiaoti Huang; Frederick J Dorey; Leonard S Marks Journal: J Urol Date: 2017-07-18 Impact factor: 7.450
Authors: James T Kearns; Anna V Faino; Lisa F Newcomb; James D Brooks; Peter R Carroll; Atreya Dash; William J Ellis; Michael Fabrizio; Martin E Gleave; Todd M Morgan; Peter S Nelson; Ian M Thompson; Andrew A Wagner; Yingye Zheng; Daniel W Lin Journal: Eur Urol Date: 2018-02-09 Impact factor: 20.096
Authors: Daniel W Lin; Yingye Zheng; Jesse K McKenney; Marshall D Brown; Ruixiao Lu; Michael Crager; Hilary Boyer; Maria Tretiakova; James D Brooks; Atreya Dash; Michael D Fabrizio; Martin E Gleave; Suzanne Kolb; Michael Liss; Todd M Morgan; Ian M Thompson; Andrew A Wagner; Athanasios Tsiatis; Andrea Pingitore; Peter S Nelson; Lisa F Newcomb Journal: J Clin Oncol Date: 2020-03-04 Impact factor: 44.544