期刊
WORLD JOURNAL OF UROLOGY
卷 30, 期 2, 页码 149-155出版社
SPRINGER
DOI: 10.1007/s00345-011-0804-y
关键词
PSA; Risk; Prostate cancer; Prostate volume; Calibration; Net benefit
资金
- European Union [SOC 95 35109, SOC 96 201869 05F022, SOC 97 201329, SOC 98 32241, PMark:LSHC-CT-2004-503011]
- Dutch Cancer Society [KWF 94-869, 98-1657, 2002-277, 2006-3518]
- Netherlands Organization for Health Research and Development [ZonMW-002822820, 22000106, 50-50110-98-311]
- Swedish Cancer Society [090107, 080315, 083455]
- Center for Translational Molecular Medicine (PCMM)
- International Agency for Research on Cancer, Lyon
- Tyrolean Prostate Cancer Early Detection Group
- San Antonio Center of Biomarkers of Risk for Prostate Cancer [U01 CA86402]
- Prostate Cancer Foundation
- Sidney Kimmel Center for Prostate and Urologic Cancers
- National Cancer Institute [P50-CA92629 SPORE]
- MRC [G0800800] Funding Source: UKRI
- Medical Research Council [G0800800] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0509-10242] Funding Source: researchfish
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.
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