Importance of prostate volume in the European Randomised Study of Screening for Prostate Cancer (ERSPC) risk calculators: Results from the prostate biopsy collaborative group

Monique J. Roobol, F. H. Schröder, Jonas Hugosson, J. Stephen Jones, Michael W. Kattan, Eric A. Klein, Freddie Hamdy, David Neal, Jenny Donovan, Dipen J. Parekh, Donna Ankerst, George Bartsch, Helmut Klocker, Wolfgang Horninger, Amine Benchikh, Gilles Salama, Arnauld Villers, Stephen J. Freedland, Daniel M. Moreira, Andrew J. VickersHans Lilja, Ewout W. Steyerberg

Research output: Contribution to journalArticle

60 Scopus citations

Abstract

Objectives: To compare the predictive performance and potential clinical usefulness of risk calculators of the European Randomized Study of Screening for Prostate Cancer (ERSPC RC) with and without information on prostate volume. Methods: We studied 6 cohorts (5 European and 1 US) with a total of 15,300 men, all biopsied and with pre-biopsy TRUS measurements of prostate volume. Volume was categorized into 3 categories (25, 40, and 60 cc), to reflect use of digital rectal examination (DRE) for volume assessment. Risks of prostate cancer were calculated according to a ERSPC DRE-based RC (including PSA, DRE, prior biopsy, and prostate volume) and a PSA + DRE model (including PSA, DRE, and prior biopsy). Missing data on prostate volume were completed by single imputation. Risk predictions were evaluated with respect to calibration (graphically), discrimination (AUC curve), and clinical usefulness (net benefit, graphically assessed in decision curves). Results: The AUCs of the ERSPC DRE-based RC ranged from 0.61 to 0.77 and were substantially larger than the AUCs of a model based on only PSA + DRE (ranging from 0.56 to 0.72) in each of the 6 cohorts. The ERSPC DRE-based RC provided net benefit over performing a prostate biopsy on the basis of PSA and DRE outcome in five of the six cohorts. Conclusions: Identifying men at increased risk for having a biopsy detectable prostate cancer should consider multiple factors, including an estimate of prostate volume.

Original languageEnglish (US)
Pages (from-to)149-155
Number of pages7
JournalWorld journal of urology
Volume30
Issue number2
DOIs
StatePublished - Apr 2012

Keywords

  • Calibration
  • Net benefit
  • Prostate cancer
  • Prostate volume
  • PSA
  • Risk

ASJC Scopus subject areas

  • Urology

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    Roobol, M. J., Schröder, F. H., Hugosson, J., Jones, J. S., Kattan, M. W., Klein, E. A., Hamdy, F., Neal, D., Donovan, J., Parekh, D. J., Ankerst, D., Bartsch, G., Klocker, H., Horninger, W., Benchikh, A., Salama, G., Villers, A., Freedland, S. J., Moreira, D. M., ... Steyerberg, E. W. (2012). Importance of prostate volume in the European Randomised Study of Screening for Prostate Cancer (ERSPC) risk calculators: Results from the prostate biopsy collaborative group. World journal of urology, 30(2), 149-155. https://doi.org/10.1007/s00345-011-0804-y