Paul Doan1, Petra Graham2, John Lahoud1, Sebastiaan Remmers3, Monique J Roobol3, Lawrence Kim1,4, Manish I Patel1,4. 1. Department of Urology, Westmead Hospital, Westmead, NSW, Australia. 2. Macquarie Business School, Macquarie University, Sydney, NSW, Australia. 3. Department of Urology, Erasmus MC, Rotterdam, The Netherlands. 4. Specialty of Surgery, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Abstract
OBJECTIVE: To externally validate and compare the performance of the European Randomized Study of Screening for Prostate Cancer risk calculator 3/4 (ERSPC-RC3/4), the Prostate Biopsy Collaborative Group risk calculator (PBCG-RC) and the van Leeuwen model to determine which prediction model would perform the best in a contemporary Australian cohort undergoing transperineal (TP) biopsy. MATERIALS AND METHODS: A retrospective review identified all patients undergoing TP biopsy across two centres. Of the 797 patients identified, 373 had the data required to test all three risk calculators. The probability of high-grade prostate cancer, defined as International Society of Urological Pathology Grade Group >1, was calculated for each patient. For each prediction model discrimination was assessed using area under the receiver-operating characteristic curve (AUC), calibration using numerical and graphical summaries, and net benefit using decision curve analysis. RESULTS: Assessment of model discrimination for detecting high-grade prostate cancer showed AUCs of 0.79 (95% confidence interval [CI] 0.74-0.84) for the ERSPC-RC3/4, 0.81 (95% CI 0.77-0.86) for the van Leeuwen model, and 0.68 (95% CI 0.63-0.74) for the PBCG-RC, compared to 0.58 (95% CI 0.52-0.65) for prostate-specific antigen alone. The ERSPC-RC3/4 was the best calibrated in the moderate-risk range of 10-40%, whilst the van Leeuwen model was the best calibrated in the low-risk range of 0-10%. The van Leeuwen model demonstrated the greatest net benefit from 10% risk onwards, followed closely by the ERSPC-RC3/4 and then the PBCG-RC. CONCLUSION: The ERPSC-RC3/4 demonstrated good performance and was comparable to the van Leeuwen model with regard to discrimination, calibration and net benefit for an Australian population undergoing TP prostate biopsy. It is one of the most accessible risk calculators with an easy-to-use online platform, therefore, we recommend that Australian urologists use the ERSPC-RC3/4 to predict risk in the clinical setting.
OBJECTIVE: To externally validate and compare the performance of the European Randomized Study of Screening for Prostate Cancer risk calculator 3/4 (ERSPC-RC3/4), the Prostate Biopsy Collaborative Group risk calculator (PBCG-RC) and the van Leeuwen model to determine which prediction model would perform the best in a contemporary Australian cohort undergoing transperineal (TP) biopsy. MATERIALS AND METHODS: A retrospective review identified all patients undergoing TP biopsy across two centres. Of the 797 patients identified, 373 had the data required to test all three risk calculators. The probability of high-grade prostate cancer, defined as International Society of Urological Pathology Grade Group >1, was calculated for each patient. For each prediction model discrimination was assessed using area under the receiver-operating characteristic curve (AUC), calibration using numerical and graphical summaries, and net benefit using decision curve analysis. RESULTS: Assessment of model discrimination for detecting high-grade prostate cancer showed AUCs of 0.79 (95% confidence interval [CI] 0.74-0.84) for the ERSPC-RC3/4, 0.81 (95% CI 0.77-0.86) for the van Leeuwen model, and 0.68 (95% CI 0.63-0.74) for the PBCG-RC, compared to 0.58 (95% CI 0.52-0.65) for prostate-specific antigen alone. The ERSPC-RC3/4 was the best calibrated in the moderate-risk range of 10-40%, whilst the van Leeuwen model was the best calibrated in the low-risk range of 0-10%. The van Leeuwen model demonstrated the greatest net benefit from 10% risk onwards, followed closely by the ERSPC-RC3/4 and then the PBCG-RC. CONCLUSION: The ERPSC-RC3/4 demonstrated good performance and was comparable to the van Leeuwen model with regard to discrimination, calibration and net benefit for an Australian population undergoing TP prostate biopsy. It is one of the most accessible risk calculators with an easy-to-use online platform, therefore, we recommend that Australian urologists use the ERSPC-RC3/4 to predict risk in the clinical setting.
Authors: Nick Lasse Beetz; Franziska Dräger; Charlie Alexander Hamm; Seyd Shnayien; Madhuri Monique Rudolph; Konrad Froböse; Sefer Elezkurtaj; Matthias Haas; Patrick Asbach; Bernd Hamm; Samy Mahjoub; Frank Konietschke; Maximilian Wechsung; Felix Balzer; Hannes Cash; Sebastian Hofbauer; Tobias Penzkofer Journal: Prostate Cancer Prostatic Dis Date: 2022-10-08 Impact factor: 5.455
Authors: Matthias Neumair; Michael W Kattan; Stephen J Freedland; Alexander Haese; Lourdes Guerrios-Rivera; Amanda M De Hoedt; Michael A Liss; Robin J Leach; Stephen A Boorjian; Matthew R Cooperberg; Cedric Poyet; Karim Saba; Kathleen Herkommer; Valentin H Meissner; Andrew J Vickers; Donna P Ankerst Journal: BMC Med Res Methodol Date: 2022-07-21 Impact factor: 4.612
Authors: Maximilian Pallauf; Fabian Steinkohl; Georg Zimmermann; Maximilian Horetzky; Pawel Rajwa; Benjamin Pradere; Andrea Katharina Lindner; Renate Pichler; Thomas Kunit; Shahrokh F Shariat; Lukas Lusuardi; Martin Drerup Journal: World J Urol Date: 2022-08-08 Impact factor: 3.661