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Development and external validation of a novel nomogram to predict prostate cancer in biopsy‐naïve patients with PSA <10 ng/ml and PI‐RADS v2.1 = 3 lesions
Objective To develop and externally validate a novel nomogram in biopsy‐naïve patients with prostate‐specific antigen (PSA)
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| Published in: | Cancer medicine (Malden, MA) MA), 2023-02, Vol.12 (3), p.2560-2571 |
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| container_title | Cancer medicine (Malden, MA) |
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| creator | Hu, Can Sun, Jiale Xu, Zhenyu Zhang, Zhiyu Zhou, Qi Xu, Jiangnan Chen, Hao Wang, Chao Ouyang, Jun |
| description | Objective
To develop and externally validate a novel nomogram in biopsy‐naïve patients with prostate‐specific antigen (PSA) |
| doi_str_mv | 10.1002/cam4.5100 |
| format | article |
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To develop and externally validate a novel nomogram in biopsy‐naïve patients with prostate‐specific antigen (PSA) <10 ng/ml and PI‐RADS v2.1 = 3 lesions.
Methods
We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By Slicer‐3D Software, the volume of all lesions was divided into two subgroups (PI‐RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort.
Results
A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate‐specific antigen density, digital rectal examination, PI‐RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm2/s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram.
Conclusion
Until now, this is the first nomogram that predicts PCa and csPCa in biopsy‐naïve patients with PSA <10 ng/ml and PI‐RADS v2.1 = 3 lesions. Furthermore, PI‐RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so‐called “double gray zone” patients.
To our knowledge, this is the first study that applied PI‐RADS 3 subgroup into nomogram. Overall, the nomogram is a promising tool for predicting prostate cancer and clinically significant prostate cancer in biopsy‐naïve patients with PSA <10 ng/ml and PI‐RADS v2.1 = 3 lesions due to the good calibration and net benefit. Our model may assist urologists in biopsy decision making for the “double gray zone” patients.</description><identifier>ISSN: 2045-7634</identifier><identifier>EISSN: 2045-7634</identifier><identifier>DOI: 10.1002/cam4.5100</identifier><identifier>PMID: 35920264</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>Antigens ; Biopsy ; Calibration ; csPCa ; Decision making ; Diffusion coefficient ; equivocal lesions ; Humans ; Lesions ; Magnetic Resonance Imaging ; Male ; nomogram ; Nomograms ; Patients ; PI‐RADS v2.1 ; Prostate cancer ; Prostate-Specific Antigen ; Prostatic Neoplasms - pathology ; Regression analysis ; Retrospective Studies ; Risk factors ; Software ; Urology</subject><ispartof>Cancer medicine (Malden, MA), 2023-02, Vol.12 (3), p.2560-2571</ispartof><rights>2022 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.</rights><rights>2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4240-33214171d0376b83d40d683291dcccd2e976eb4c27d265f14cebfa79d0b307653</citedby><cites>FETCH-LOGICAL-c4240-33214171d0376b83d40d683291dcccd2e976eb4c27d265f14cebfa79d0b307653</cites><orcidid>0000-0002-8957-948X ; 0000-0002-9583-9348 ; 0000-0002-8040-6267</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2777853881/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2777853881?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11562,25753,27924,27925,37012,37013,44590,46052,46476,53791,53793,74998</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35920264$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hu, Can</creatorcontrib><creatorcontrib>Sun, Jiale</creatorcontrib><creatorcontrib>Xu, Zhenyu</creatorcontrib><creatorcontrib>Zhang, Zhiyu</creatorcontrib><creatorcontrib>Zhou, Qi</creatorcontrib><creatorcontrib>Xu, Jiangnan</creatorcontrib><creatorcontrib>Chen, Hao</creatorcontrib><creatorcontrib>Wang, Chao</creatorcontrib><creatorcontrib>Ouyang, Jun</creatorcontrib><title>Development and external validation of a novel nomogram to predict prostate cancer in biopsy‐naïve patients with PSA <10 ng/ml and PI‐RADS v2.1 = 3 lesions</title><title>Cancer medicine (Malden, MA)</title><addtitle>Cancer Med</addtitle><description>Objective
To develop and externally validate a novel nomogram in biopsy‐naïve patients with prostate‐specific antigen (PSA) <10 ng/ml and PI‐RADS v2.1 = 3 lesions.
Methods
We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By Slicer‐3D Software, the volume of all lesions was divided into two subgroups (PI‐RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort.
Results
A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate‐specific antigen density, digital rectal examination, PI‐RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm2/s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram.
Conclusion
Until now, this is the first nomogram that predicts PCa and csPCa in biopsy‐naïve patients with PSA <10 ng/ml and PI‐RADS v2.1 = 3 lesions. Furthermore, PI‐RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so‐called “double gray zone” patients.
To our knowledge, this is the first study that applied PI‐RADS 3 subgroup into nomogram. Overall, the nomogram is a promising tool for predicting prostate cancer and clinically significant prostate cancer in biopsy‐naïve patients with PSA <10 ng/ml and PI‐RADS v2.1 = 3 lesions due to the good calibration and net benefit. Our model may assist urologists in biopsy decision making for the “double gray zone” patients.</description><subject>Antigens</subject><subject>Biopsy</subject><subject>Calibration</subject><subject>csPCa</subject><subject>Decision making</subject><subject>Diffusion coefficient</subject><subject>equivocal lesions</subject><subject>Humans</subject><subject>Lesions</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>nomogram</subject><subject>Nomograms</subject><subject>Patients</subject><subject>PI‐RADS v2.1</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Software</subject><subject>Urology</subject><issn>2045-7634</issn><issn>2045-7634</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1kk1uEzEUgEcIRKvQBRdAltjAIon_ZjwjAVKU8hOpiIrC2vLYb1JHM-PBnqRkxxE4QiQOwB3CTTgJTlKqFgkv7Cf70_fek1-SPCZ4RDCmY60aPkpjeC85ppinQ5Exfv9WfJSchLDAcQlMM0EeJkcsLWiM-XHy4xRWULuugbZHqjUIvvbgW1WjlaqtUb11LXIVUqh1EYx74-ZeNah3qPNgrO7j6UKvekBatRo8si0qrevC-ve376369XMFqIuimCGgK9tfovOLCXpB8HbTzsdNvU97Povwx8npBVrREdluXm43DNUQYvrwKHlQqTrAyfU5SD6_ef1p-m549uHtbDo5G2pOOR4yRgknghjMRFbmzHBsspzRghittaFQiAxKrqkwNEsrwjWUlRKFwSXDIkvZIJkdvMaphey8bZRfS6es3F84P5fK91bXIIFWJhfaZJU2nDGWk0yBUFTlaZWCEtH16uDqlmUDRsfmvarvSO--tPZSzt1KFgUrSFQOkmfXAu--LCH0srFBQ12rFtwySJrFdgQtch7Rp_-gC7fc_WGkhBB5yvKcROr5gdLxu4KH6qYYguVukuRukuRukiL75Hb1N-TfuYnA-ABc2RrW_zfJ6eQ93yv_ALof10Q</recordid><startdate>202302</startdate><enddate>202302</enddate><creator>Hu, Can</creator><creator>Sun, Jiale</creator><creator>Xu, Zhenyu</creator><creator>Zhang, Zhiyu</creator><creator>Zhou, Qi</creator><creator>Xu, Jiangnan</creator><creator>Chen, Hao</creator><creator>Wang, Chao</creator><creator>Ouyang, Jun</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><general>Wiley</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-8957-948X</orcidid><orcidid>https://orcid.org/0000-0002-9583-9348</orcidid><orcidid>https://orcid.org/0000-0002-8040-6267</orcidid></search><sort><creationdate>202302</creationdate><title>Development and external validation of a novel nomogram to predict prostate cancer in biopsy‐naïve patients with PSA <10 ng/ml and PI‐RADS v2.1 = 3 lesions</title><author>Hu, Can ; Sun, Jiale ; Xu, Zhenyu ; Zhang, Zhiyu ; Zhou, Qi ; Xu, Jiangnan ; Chen, Hao ; Wang, Chao ; Ouyang, Jun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4240-33214171d0376b83d40d683291dcccd2e976eb4c27d265f14cebfa79d0b307653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Antigens</topic><topic>Biopsy</topic><topic>Calibration</topic><topic>csPCa</topic><topic>Decision making</topic><topic>Diffusion coefficient</topic><topic>equivocal lesions</topic><topic>Humans</topic><topic>Lesions</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>nomogram</topic><topic>Nomograms</topic><topic>Patients</topic><topic>PI‐RADS v2.1</topic><topic>Prostate cancer</topic><topic>Prostate-Specific Antigen</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Software</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hu, Can</creatorcontrib><creatorcontrib>Sun, Jiale</creatorcontrib><creatorcontrib>Xu, Zhenyu</creatorcontrib><creatorcontrib>Zhang, Zhiyu</creatorcontrib><creatorcontrib>Zhou, Qi</creatorcontrib><creatorcontrib>Xu, Jiangnan</creatorcontrib><creatorcontrib>Chen, Hao</creatorcontrib><creatorcontrib>Wang, Chao</creatorcontrib><creatorcontrib>Ouyang, Jun</creatorcontrib><collection>Wiley Open Access</collection><collection>Wiley Free Archive</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biological Sciences</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Biological Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Cancer medicine (Malden, MA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hu, Can</au><au>Sun, Jiale</au><au>Xu, Zhenyu</au><au>Zhang, Zhiyu</au><au>Zhou, Qi</au><au>Xu, Jiangnan</au><au>Chen, Hao</au><au>Wang, Chao</au><au>Ouyang, Jun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development and external validation of a novel nomogram to predict prostate cancer in biopsy‐naïve patients with PSA <10 ng/ml and PI‐RADS v2.1 = 3 lesions</atitle><jtitle>Cancer medicine (Malden, MA)</jtitle><addtitle>Cancer Med</addtitle><date>2023-02</date><risdate>2023</risdate><volume>12</volume><issue>3</issue><spage>2560</spage><epage>2571</epage><pages>2560-2571</pages><issn>2045-7634</issn><eissn>2045-7634</eissn><abstract>Objective
To develop and externally validate a novel nomogram in biopsy‐naïve patients with prostate‐specific antigen (PSA) <10 ng/ml and PI‐RADS v2.1 = 3 lesions.
Methods
We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By Slicer‐3D Software, the volume of all lesions was divided into two subgroups (PI‐RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort.
Results
A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate‐specific antigen density, digital rectal examination, PI‐RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm2/s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram.
Conclusion
Until now, this is the first nomogram that predicts PCa and csPCa in biopsy‐naïve patients with PSA <10 ng/ml and PI‐RADS v2.1 = 3 lesions. Furthermore, PI‐RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so‐called “double gray zone” patients.
To our knowledge, this is the first study that applied PI‐RADS 3 subgroup into nomogram. Overall, the nomogram is a promising tool for predicting prostate cancer and clinically significant prostate cancer in biopsy‐naïve patients with PSA <10 ng/ml and PI‐RADS v2.1 = 3 lesions due to the good calibration and net benefit. Our model may assist urologists in biopsy decision making for the “double gray zone” patients.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>35920264</pmid><doi>10.1002/cam4.5100</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-8957-948X</orcidid><orcidid>https://orcid.org/0000-0002-9583-9348</orcidid><orcidid>https://orcid.org/0000-0002-8040-6267</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Antigens Biopsy Calibration csPCa Decision making Diffusion coefficient equivocal lesions Humans Lesions Magnetic Resonance Imaging Male nomogram Nomograms Patients PI‐RADS v2.1 Prostate cancer Prostate-Specific Antigen Prostatic Neoplasms - pathology Regression analysis Retrospective Studies Risk factors Software Urology |
| title | Development and external validation of a novel nomogram to predict prostate cancer in biopsy‐naïve patients with PSA <10 ng/ml and PI‐RADS v2.1 = 3 lesions |
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