Prostate cancer prevention trial risk calculator 2.0 for the prediction of low- vs high-grade prostate cancer

Donna P. Ankerst, Josef Hoefler, Sebastian Bock, Phyllis J. Goodman, Andrew Vickers, Javier Hernandez, Lori J. Sokoll, Martin G. Sanda, John T. Wei, Robin J. Leach, Ian M. Thompson

Research output: Contribution to journalArticle

Abstract

Objective To modify the Prostate Cancer Prevention Trial risk calculator (PCPTRC) to predict low- vs high-grade (Gleason grade ≥7) prostate cancer and incorporate percent free-prostate-specific antigen (PSA). Methods Data from 6664 Prostate Cancer Prevention Trial placebo arm biopsies (5826 individuals), where prostate-specific antigen and digital rectal examination results were available within 1 year before the biopsy and PSA was ≤10 ng/mL, were used to develop a nominal logistic regression model to predict the risk of no vs low-grade (Gleason grade ;lt&7) vs high-grade cancer (Gleason grade ≥7). Percent free-PSA was incorporated into the model based on likelihood ratio analysis of a San Antonio Biomarkers of Risk cohort. Models were externally validated on 10 Prostate Biopsy Collaborative Group cohorts and 1 Early Detection Research Network reference set. Results Of all the Prostate Cancer Prevention Trial biopsies, 5468 (82.1%) were negative for prostate cancer, 942 (14.1%) detected low-grade, and 254 (3.8%) detected high-grade disease. Significant predictors were (log base 2) PSA (odds ratio for low-grade vs no cancer, 1.29*; high-grade vs no cancer, 2.02*; high-grade vs low-grade cancer, 1.57*), digital rectal examination (0.96, 1.49*, 1.55*, respectively), age (1.02*, 1.05*, 1.03*, respectively), African American race (1.13, 2.83*, 2.51*, respectively), prior biopsy (0.63*, 0.81, 1.27, respectively), and family history (1.31*, 1.25, 0.95, respectively), where* indicates P value ≤.05. The new PCPTRC 2.0 either with or without percent free-PSA (also significant by the likelihood ratio method) validated well externally. Conclusion By differentiating the risk of low- vs high-grade disease on biopsy, PCPTRC 2.0 better enables physician-patient counseling concerning whether to proceed to biopsy.

Original languageEnglish (US)
Pages (from-to)1362-1368
Number of pages7
JournalUrology
Volume83
Issue number6
DOIs
StatePublished - Jun 2014

ASJC Scopus subject areas

  • Urology

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    Ankerst, D. P., Hoefler, J., Bock, S., Goodman, P. J., Vickers, A., Hernandez, J., Sokoll, L. J., Sanda, M. G., Wei, J. T., Leach, R. J., & Thompson, I. M. (2014). Prostate cancer prevention trial risk calculator 2.0 for the prediction of low- vs high-grade prostate cancer. Urology, 83(6), 1362-1368. https://doi.org/10.1016/j.urology.2014.02.035