Details

Autor(en) / Beteiligte

• Wang, Nancy N.
• Zhou, Steve R.
• Chen, Leo
• Tibshirani, Robert
• Fan, Richard E.
• Ghanouni, Pejman
• Thong, Alan E.
• To'o, Katherine J.
• Ghabili, Kamyar
• Nix, Jeffrey W.
• Gordetsky, Jennifer B.
• Sprenkle, Preston
• Rais-Bahrami, Soroush
• Sonn, Geoffrey A.

Titel

The stanford prostate cancer calculator: Development and external validation of online nomograms incorporating PIRADS scores to predict clinically significant prostate cancer

Ist Teil von

• Urologic oncology, 2021-12, Vol.39 (12), p.831.e19-831.e27

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• •A nomogram combining mpMRI with other clinical variables accurately predicts the presence of clinically-significant prostate cancer.•Elevated PSAD highly predictive of clinically-significant prostate cancer.•African American race in this study does not confer a higher risk for prostate cancer. While multiparametric MRI (mpMRI) has high sensitivity for detection of clinically significant prostate cancer (CSC), false positives and negatives remain common. Calculators that combine mpMRI with clinical variables can improve cancer risk assessment, while providing more accurate predictions for individual patients. We sought to create and externally validate nomograms incorporating Prostate Imaging Reporting and Data System (PIRADS) scores and clinical data to predict the presence of CSC in men of all biopsy backgrounds. Data from 2125 men undergoing mpMRI and MR fusion biopsy from 2014 to 2018 at Stanford, Yale, and UAB were prospectively collected. Clinical data included age, race, PSA, biopsy status, PIRADS scores, and prostate volume. A nomogram predicting detection of CSC on targeted or systematic biopsy was created. Biopsy history, Prostate Specific Antigen (PSA) density, PIRADS score of 4 or 5, Caucasian race, and age were significant independent predictors. Our nomogram—the Stanford Prostate Cancer Calculator (SPCC)—combined these factors in a logistic regression to provide stronger predictive accuracy than PSA density or PIRADS alone. Validation of the SPCC using data from Yale and UAB yielded robust AUC values. The SPCC combines pre-biopsy mpMRI with clinical data to more accurately predict the probability of CSC in men of all biopsy backgrounds. The SPCC demonstrates strong external generalizability with successful validation in two separate institutions. The calculator is available as a free web-based tool that can direct real-time clinical decision-making.