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Development and external validation of an extended 10-core biopsy nomogram
Felix K-H Chun1, Alberto Briganti, Markus Graefen
1Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada.
European Urology
|October 3, 2006
Summary
A new prostate cancer prediction tool shows improved accuracy over older models in men undergoing extended biopsy schemes. This tool helps determine the optimal number of biopsy cores for better detection rates.
Area of Science:
- Urology
- Oncology
- Medical Informatics
Background:
- Sextant biopsy nomograms, previously validated, are used to predict prostate cancer.
- Extended biopsy schemes (≥10 cores) are now common, potentially affecting nomogram accuracy.
Purpose of the Study:
- To evaluate the accuracy of a prior sextant biopsy nomogram in men receiving ≥10 cores.
- To develop a more accurate predictive tool for prostate cancer detection.
Main Methods:
- Validated a prior nomogram using age, DRE, PSA, and %free PSA in 2900 men.
- Developed new multivariable logistic regression models (LRM) incorporating sampling density (SD).
- Internally validated the new nomogram in 1162 men and externally in three cohorts (n=1738).
Main Results:
- The prior nomogram showed 70% accuracy in contemporary validation.
- The new nomogram achieved 77% internal and 73-76% external validation accuracy.
- Sampling density improved predictive accuracy in extended biopsy schemes.
Conclusions:
- Previously developed nomograms are less accurate with extended biopsy protocols.
- A new predictive tool incorporating sampling density offers improved prostate cancer prediction.
- The new tool aids in optimizing the biopsy core number relative to gland volume for ideal detection rates.
