Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Chun, FK; Haese, A; Ahyai, SA; Walz, J; Suardi, N; Capitanio, U; Graefen, M; Erbersdobler, A; Huland, H; Karakiewicz, PI.
Critical assessment of tools to predict clinically insignificant prostate cancer at radical prostatectomy in contemporary men.
Cancer. 2008; 113(4):701-9
Doi: 10.1002/cncr.23610
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Ahyai Sascha
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- Abstract:
- BACKGROUND: Overtreatment of prostate cancer (PCa) is a concern, especially in patients who might qualify for the diagnosis of insignificant prostate cancer (IPCa). The ability to identify IPCa prior to definitive therapy was tested. METHODS: In a cohort of 1132 men a nomogram was developed to predict the probability of IPCa. Predictors consisted of prostate-specific antigen (PSA), clinical stage, biopsy Gleason sum, core cancer length and percentage of positive biopsy cores (percent positive cores). IPCa was defined as organ-confined PCa (OC) with tumor volume (TV) <0.5 cc and without Gleason 4 or 5 patterns. Finally, an external validation of the most accurate IPCa nomogram was performed in the same group. RESULTS: IPCa was pathologically confirmed in 65 (5.7%) men. The 200 bootstrap-corrected predictive accuracy of the new nomogram was 90% versus 81% for the older nomogram. However, in cutoff-based analyses of patients who were qualified by our and the older nomograms as high probability for IPCa, respectively 63% and 45% harbored aggressive PCa variants at radical prostatectomy (Gleason score 7-10, ECE, SVI, and/or LNI). CONCLUSIONS: Despite a high accuracy, currently available models for prediction of IPCa are incorrect in 10% to 20% of predictions. The rate of misclassification is even further inflated when specific cutoffs are used. As a consequence, extreme caution is advised when statistical tools are used to assign the diagnosis of IPCa.
- Find related publications in this database (using NLM MeSH Indexing)
- Biopsy - administration & dosage
- Humans - administration & dosage
- Male - administration & dosage
- Nomograms - administration & dosage
- Predictive Value of Tests - administration & dosage
- Prostate-Specific Antigen - administration & dosage
- Prostatectomy - administration & dosage
- Prostatic Neoplasms - diagnosis, surgery
- Risk Assessment - administration & dosage
- Tumor Burden - administration & dosage
- Find related publications in this database (Keywords)
- clinically insignificant prostate cancer
- clinically meaningful prostate cancer
- tumor volume
- nomogram