Incorporating PHI in decision making: external validation of the Rotterdam risk calculators for detection of prostate cancer.

Autor: Rius Bilbao L; Department of Urology, Barrualde-Galdakao Integrated Health Organisation, Osakidetza Basque Health Service, Calle Itsasondo 10, 3B 48993, Getxo Bizkaia, Spain. leire.rius.bilbao@gmail.com.; Biocruces Bizkaia Health Research Institute, Barakaldo, Spain. leire.rius.bilbao@gmail.com., Aguirre Larracoechea U; Research Unit, Barrualde-Galdakao Integrated Health Organisation, Osakidetza Basque Health Service, Galdakao, Spain.; Kronikgune Institute for Health Services Research, Barakaldo, Spain.; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Galdakao, Spain., Valladares Gomez C; Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.; Department of Clinical Laboratory Medicine, Ezkerraldea-Enkarterri-Cruces Integrated Health Organisation, Osakidetza Basque Health Service, Barakaldo, Spain., Remmers S; Department of Urology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands., Mar Medina C; Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.; Department of Clinical Laboratory Medicine, Barrualde-Galdakao Integrated Health Organisation, Osakidetza Basque Health Service, Galdakao, Spain.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2024 Mar 13; Vol. 42 (1), pp. 141. Date of Electronic Publication: 2024 Mar 13.
DOI: 10.1007/s00345-024-04833-5
Abstrakt: Purpose: External validation of existing risk calculators (RC) to assess the individualized risk of detecting prostate cancer (PCa) in prostate biopsies is needed to determine their clinical usefulness. The objective was to externally validate the Rotterdam Prostate Cancer RCs 3 and 4 (RPCRC-3/4) and that incorporating PHI (RPCRC-PHI) in a contemporary Spanish cohort.
Methods: Multicenter prospective study that included patients suspicious of harboring PCa. Men who attended the urology consultation were tested for PHI before prostate biopsy. To evaluate the performance of the prediction models: discrimination (receiver operating characteristic (ROC) curves), calibration and net benefit [decision curve analysis (DCA)] were calculated. These analyses were carried out for detection of any PCa and clinically significant (cs)PCa, defined as ISUP grade ≥ 2.
Results: Among the 559 men included, 337 (60.28%) and 194 (34.7%) were diagnosed of PCa and csPCa, respectively. RPCRC-PHI had the best discrimination ability for detection of PCa and csPCa with AUCs of 0.85 (95%CI 0.82-0.88) and 0.82 (95%CI 0.78-0.85), respectively. Calibration plots showed that RPCRC-3/4 underestimates the risk of detecting PCa showing the need for recalibration. In DCA, RPCRC-PHI shows the highest net benefit compared to biopsy all men.
Conclusions: The RPCRC-PHI performed properly in a contemporary clinical setting, especially for prediction of csPCa.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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