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Adaptation of the prostate biopsy collaborative group risk calculator in patients with PSA less than 10 ng/ml improves its performance

  • Urology - Original Paper
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Abstract

Purposes

The prostate biopsy collaborative group risk calculator (PBCGRC) is a newly developed risk estimator for predicting prostate biopsy outcomes. However, its clinical usefulness is still unknown within the so-called gray area of PSA values. This study aimed to determine whether updating the PBCGRC improves its predictive performance for predicting any-grade and high-grade (HG), defined as biopsy Gleason score ≥ 7, prostate cancer (PCa) in patients with prostate-specific antigen (PSA) less than 10 ng/ml.

Methods

The risk of any-grade and HGPCa was calculated using the PBCG risk calculation formulas updated by recalibration in the large, logistic recalibration and model revision. Predictive performances of the PBCGRC and the updated models were compared using discrimination, calibration, and clinical utility.

Results

Within the study sample of 526 patients, PCa was detected in 193 (36.7%), and 78 (14.8%) of them had HGPCa. According to the calibration curves, the PBCGRC overestimated the risk of PCa. Predictive accuracy of the revised model was higher [the area under the receiver-operating characteristic curve (AUCs), 65.4% and 70.2%] than that of the PBCGRC (AUCs, 60.4% and 64.3%) for any-grade and HGPCa. The net benefit was greater for model revision in comparison with the original model.

Conclusion

The performance accuracy of PBCGRC for the prediction of any and HGPC in men undergoing prostate biopsy with PSA levels below 10 ng/ml is suboptimal. The model revision resulted with significant improvement in model performance. However, external validation of the revised model is necessary before its routine use in clinical practice.

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Acknowledgements

The authors were financially supported through a research Grant N0175014 and N175007 of the Ministry of Science and Technological Development of Serbia. The authors thank the Ministry for this support.

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Authors and Affiliations

  1. Department of Urology, Clinic of Urology and Nephrology, Clinical Centre “Kragujevac”, Zmaj Jovina 30, 34 000, Kragujevac, Serbia

    Miroslav Stojadinovic & Slobodan Jankovic

  2. Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia

    Miroslav Stojadinovic

  3. Department of Mathematics and Informatics Faculty of Science, University of Kragujevac, Kragujevac, Serbia

    Teodora Trifunovic

  4. Pharmacology and Toxicology Department, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia

    Slobodan Jankovic

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  1. Miroslav Stojadinovic
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  2. Teodora Trifunovic
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Correspondence to Miroslav Stojadinovic.

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Stojadinovic, M., Trifunovic, T. & Jankovic, S. Adaptation of the prostate biopsy collaborative group risk calculator in patients with PSA less than 10 ng/ml improves its performance. Int Urol Nephrol 52, 1811–1819 (2020). https://doi.org/10.1007/s11255-020-02517-8

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