Head‐to‐head comparison of two online nomograms for prostate biopsy outcome prediction

• Published in: BJU international Vol. 107; no. 11; pp. 1780 - 1783
• Main Authors: Oliveira, Mário, Marques, Vera, Carvalho, António Pedro, Santos, Américo
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.2011; Wiley-Blackwell
• Subjects: Age Factors; Aged; Biological and medical sciences; biopsy; Biopsy, Needle - standards; Cohort Studies; Gynecology. Andrology. Obstetrics; Humans; Immunohistochemistry; Male; Male genital diseases; Medical sciences; Middle Aged; Neoplasm Invasiveness - pathology; Nephrology. Urinary tract diseases; nomogram; Nomograms; Predictive Value of Tests; Prognosis; prostate cancer; Prostate-Specific Antigen - blood; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - epidemiology; Prostatic Neoplasms - pathology; Retrospective Studies; Risk Assessment; Sensitivity and Specificity; Tumors; Tumors of the urinary system; Ultrasonography, Interventional; Urinary tract. Prostate gland; Nephrology; Head; Urinary system disease; Prognosis; Prostate disease; Nomogram; Prediction; Malignant tumor; Urology; Anatomic pathology; Biopsy; Nomograms; Predictive factor; Urogenital system; Male genital diseases; Prostate cancer; Prostate; Comparative study; Cancer
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2010.09727.x

Study Type – Diagnosis (exploratory cohort)
Level of Evidence 2b What’s known on the subject? and What does the study add? In recent years, several nomograms were developed in an effort to decrease the number of unnecessary prostate biopsies. The European SWOP‐PRI and the North American PCPT are among the most popular. However, evidence on the relative predictive accuracy is lacking. A head‐to‐head comparison on the diagnostic accuracy of two previously validated prostate cancer risk predictors on biopsy confirmed the superiority of these tools over PSA alone. Moreover, in the studied population, the European SWOP‐PRI proved to be more accurate than the North American PCPT‐CRC. OBJECTIVE • To compare the diagnostic accuracy of two previously validated prostate cancer risk predictors on biopsy. PATIENTS AND METHODS • In total, 390 consecutive patients submitted to 10‐core systematic transrectal prostate biopsy at our institution were included in this retrospective study. • External validation of a European (European Randomized Study of Screening for Prostate Cancer derived Prostate Risk Indicator; SWOP‐PRI) and a North American (Prostate Cancer Prevention Trial Cancer Risk Calculator; PCPT‐CRC) nomogram was performed. • The predictive accuracy of these online available nomograms was calculated based on the area under the curve derived from receiver–operator characteristic curves and then compared using the DeLong method. RESULTS • Both tools were confirmed to be superior to prostate‐specific antigen alone. Moreover, the SWOP‐PRI (77.9%) displays a 7.96% increase in the predictive accuracy compared to the PCPT‐CRC (69.9%) in a statistically significant fashion (P= 0.002). CONCLUSIONS • The results obtained in the present study confirm the utility of nomograms with respect to biopsy outcome prediction in patients with suspicion of prostate cancer. • In the current sample of patients, the European‐based nomogram appears to be more accurate than the North American nonogram, which lacks information regarding prostate volume and prostatic ultrasonographic lesions. • To our knowledge, this is the first study to compare the accuracy of these popular risk calculators in a specific population.