Observational Study Comparing the Accuracy/variability Between the ERSPC and the PCPT Risk Calculators for the Prediction of Significant Prostate Cancer in Patients with PSA <10 Ng/mL

Overview

Journal BMJ Open

Specialty General Medicine

Date 2019 Nov 15

PMID 31722940

Citations 3

Authors

Enrique Gomez Gomez

Juan Jose Salamanca Bustos

Julia Carrasco Valiente

Jose Luis Fernandez Rueda

Ana Blanca

Jose Valero Rosa

Ines Bravo Arrebola

Javier Marquez Lopez

Juan Manuel Jimenez Vacas

Raul Luque

Maria Jose Requena Tapia

Affiliations

Soon will be listed here.

Abstract

Introduction: Risk calculators (RCs) are easy-to-use tools considering available clinical variables that could help to select those patients with risk of prostate cancer (PCa) who should undergo a prostate biopsy.

Objective: To perform a comparison for the prediction of significant PCa (SigPCa) between the European Randomised Study of Screening for PCa (ERSPC) and the PCa Prevention Trial (PCPT) RCs in patients with prostate-specific antigen (PSA) between 3 and 10 ng/mL through an evaluation of the accuracy/variability between two consecutive PSA values.

Setting: An observational study in a major university hospital in the south of Spain.

Methods And Participants: An observational study was performed in patients who underwent a prostate biopsy. SigPCa probabilities were calculated with the two PSA measures using ERSPC3/4+digital rectal examination and PCPT v2+free PSA RCs. The prediction of SigPCa was determined by the area under the receiver operating characteristic curve (AUC). Calibration, discrimination and decision curve analysis were studied. The variability between both RCs' agreement was compared using Cohen's kappa coefficient.

Results: 510 patients were analysed (87 diagnosed with SigPCa). The median PSA values were 5.3 and 5 ng/mL for PSA1 and PSA2, respectively. Both RCs overestimated the risk in the case of high-risk probabilities. Discriminative ability for SigPCa was similar between models with an AUC=0.73 (0.68-0.79) for ERSPC-RC versus 0.73 (0.67-0.79) for PCPT-RC. ERSPC-RC showed less variability than PCPT-RC, with a constant agreement (k=0.7-0.8) for usual range of clinical decision-making. Remarkably, a higher number of biopsies would be avoided using the ERSPC-RC, but more SigPCa would be missed along all the risk probabilities.

Conclusions: Both RCs performed similar in the prediction of SigPCa. However, ERSPC-RC seems to be more stable for intraindividual PSA variations.

Citing Articles

Risk calculators for the detection of prostate cancer: a systematic review.

Denijs F, van Harten M, Meenderink J, Leenen R, Remmers S, Venderbos L Prostate Cancer Prostatic Dis. 2024; 27(3):544-557.

PMID: 38830997 DOI: 10.1038/s41391-024-00852-w.

A prostate biopsy risk calculator based on MRI: development and comparison of the Prospective Loyola University multiparametric MRI (PLUM) and Prostate Biopsy Collaborative Group (PBCG) risk calculators.

Patel H, Koehne E, Shea S, Fang A, Gerena M, Gorbonos A BJU Int. 2022; 131(2):227-235.

PMID: 35733400 PMC: 9772358. DOI: 10.1111/bju.15835.

PSA Based Biomarkers, Imagistic Techniques and Combined Tests for a Better Diagnostic of Localized Prostate Cancer.

Munteanu V, Munteanu R, Gulei D, Schitcu V, Petrut B, Berindan Neagoe I Diagnostics (Basel). 2020; 10(10).

PMID: 33050493 PMC: 7601671. DOI: 10.3390/diagnostics10100806.

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