A clinically significant prostate cancer predictive model using digital rectal examination prostate volume category to stratify initial prostate cancer suspicion and reduce magnetic resonance imaging demand

Morote, Juan ; Borque Fernando, Ángel (Universidad de Zaragoza) ; Triquell, Marina ; Campistol, Miriam ; Celma, Anna ; Regis, Lucas ; Abascal, José M. ; Servian, Pol ; Planas, Jacques ; Mendez, Olga ; Esteban, Luis M. ; Trilla, Enrique

Resumen: A predictive model including age, PCa family history, biopsy status (initial vs repeat), DRE (normal vs abnormal), serum prostate-specific antigen (PSA), and DRE prostate volume ca-tegory was developed to stratify initial PCa suspicion in 1486 men with PSA > 3 ng/mL and/or abnormal DRE, in whom mpMRI followed; 2- to 4-core TRUS-guided biopsies where Prostate Imaging Report and Data System (PI-RADS) > 3 lesions and/or 12-core TRUS systematic biopsies were performed in one academic institution between 1 January 2016–31 December 2019. The csPCa detection rate, defined as International Society of Uro-Pathology grade group 2 or higher, was 36.9%. An external validation of designed BCN-RC 1 was carried out on 946 men from two other institutions in the same metropolitan area, using the same criteria of PCa suspicion and diagnostic approach, yielded a csPCa detection rate of 40.8%. The areas under the receiver operating characteristic curves of BCN-RC 1 were 0.823 (95% CI: 0.800–0.846) in the development cohort and 0.837 (95% CI: 0.811–0.863) in the validation cohort (p = 0.447). In both cohorts, BCN-RC 1 exhibited net benefit over performing mpMRI in all men from 8 and 12% risk thresholds, respectively. At 0.95 sensitivity of csPCa, the specificities of BCN-RC 1 were 0.24 (95% CI: 0.22–0.26) in the development cohort and 0.34 (95% CI: 0.31–0.37) in the validation cohort (p < 0.001). The percentages of avoided mpMRI scans were 17.2% in the development cohort and 22.3% in the validation cohort, missing between 1.8% and 2% of csPCa among men at risk of PCa. In summary, BCN-RC 1 can stratify initial PCa suspicion, reducing the demand of mpMRI, with an acceptable loss of csPCa.

Idioma: Inglés

DOI: 10.3390/cancers14205100

Año: 2022

Publicado en: Cancers 14, 20 (2022), 5100 [14 pp]
ISSN: 2072-6694

Factor impacto JCR: 5.2 (2022)

Categ. JCR: ONCOLOGY rank: 72 / 241 = 0.299 (2022) - Q2 - T1

Factor impacto CITESCORE: 7.4 - Medicine (Q1) - Biochemistry, Genetics and Molecular Biology (Q2)

Factor impacto SCIMAGO: 1.312 - Oncology (Q1) - Cancer Research (Q2)

Financiación: info:eu-repo/grantAgreement/ES/ISCIII/PI20/01666

Tipo y forma: Article (Published version)

Área (Departamento): Área Urología (Dpto. Cirugía)