Predicting Low-Risk Prostate Cancer from Transperineal Saturation Biopsies
Introduction. To assess the performance of five previously described clinicopathological definitions of low-risk prostate cancer (PC). Materials and Methods. Men who underwent radical prostatectomy (RP) for clinical stage </=T2, PSA <10 ng/mL, Gleason score <8 PC, diagnosed by transperineal template-guided saturation biopsy were included. The performance of five previously described criteria (i.e., criteria 1-5, criterion 1 stringent (Gleason score 6 + </=5 mm total max core length PC + </=3 mm max per core length PC) up to criterion 5 less stringent (Gleason score 6-7 with </=5% Gleason grade 4) was analysed to assess ability of each to predict insignificant disease in RP specimens (defined as Gleason score </=6 and total tumour volume <2.5 mL, or Gleason score 7 with </=5% grade 4 and total tumour volume <0.7 mL). Results. 994 men who underwent RP were included. Criterion 4 (Gleason score 6) performed best with area under the curve of receiver operating characteristics 0.792. At decision curve analysis, criterion 4 was deemed clinically the best performing transperineal saturation biopsy-based definition for low-risk PC. Conclusions. Gleason score 6 disease demonstrated a superior trade-off between sensitivity and specificity for clarifying low-risk PC that can guide treatment and be used as reference test in diagnostic studies.
|ISBN||2090-3111 (Print) 2090-312X (Linking)|
|Authors||van Leeuwen, P. J.; Siriwardana, A.; Roobol, M.; Ting, F.; Nieboer, D.; Thompson, J.; Delprado, W.; Haynes, A. M.; Brenner, P.; Stricker, P.;|
|Publisher Name||Prostate Cancer|
|URL link to publisher's version||http://www.ncbi.nlm.nih.gov/pubmed/27148459|
|OpenAccess link to author's accepted manuscript version||https://publications.gimr.garvan.org.au/open-access/13931|