Post by Uncle on Oct 1, 2015 22:47:45 GMT
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Physicians' Desk Reference® September No.5 Top Read Article
A multi-institutional prospective trial in the USA confirms that the 4kscore accurately identifies men with high-grade prostate cancer
European Urology, 09/08/2015 Clinical Article
Parekh DJ, et al. – In this study, authors want to perform the first prospective evaluation of the 4Kscore in predicting Gleason ≥ 7 PCa in the USA. The 4Kscore showed excellent diagnostic performance in detecting significant PCa. It is a useful tool in selecting men who have significant disease and are most likely to benefit from a prostate biopsy from men with no cancer or indolent cancer.
Methods
Prospective enrollment of 1012 men scheduled for prostate biopsy, regardless of prostate–specific antigen level or clinical findings, was conducted at 26 US urology centers between October 2013 and April 2014.
The 4Kscore.
The primary outcome was Gleason ≥ 7 PCa on prostate biopsy.
The area under the receiver operating characteristic curve, risk calibration, and decision curve analysis (DCA) were determined, along with comparisons of probability cutoffs for reducing the number of biopsies and their impact on delaying diagnosis.
Results
Gleason ≥7 PCa was found in 231 (23%) of the 1012 patients.
The 4Kscore showed excellent calibration and demonstrated higher discrimination (AUC 0.82) and net benefit compared to a modified Prostate Cancer Prevention Trial Risk Calculator 2.0 model and standard of care (biopsy for all men) according to DCA.
A possible reduction of 30–58% in the number biopsies was identified with delayed diagnosis in only 1.3–4.7% of Gleason ≥ 7 PCa cases, depending on the threshold used for biopsy.
Pathological assessment was performed according to the standard of care at each site without centralized review.
Physicians' Desk Reference® September No.5 Top Read Article
A multi-institutional prospective trial in the USA confirms that the 4kscore accurately identifies men with high-grade prostate cancer
European Urology, 09/08/2015 Clinical Article
Parekh DJ, et al. – In this study, authors want to perform the first prospective evaluation of the 4Kscore in predicting Gleason ≥ 7 PCa in the USA. The 4Kscore showed excellent diagnostic performance in detecting significant PCa. It is a useful tool in selecting men who have significant disease and are most likely to benefit from a prostate biopsy from men with no cancer or indolent cancer.
Methods
Prospective enrollment of 1012 men scheduled for prostate biopsy, regardless of prostate–specific antigen level or clinical findings, was conducted at 26 US urology centers between October 2013 and April 2014.
The 4Kscore.
The primary outcome was Gleason ≥ 7 PCa on prostate biopsy.
The area under the receiver operating characteristic curve, risk calibration, and decision curve analysis (DCA) were determined, along with comparisons of probability cutoffs for reducing the number of biopsies and their impact on delaying diagnosis.
Results
Gleason ≥7 PCa was found in 231 (23%) of the 1012 patients.
The 4Kscore showed excellent calibration and demonstrated higher discrimination (AUC 0.82) and net benefit compared to a modified Prostate Cancer Prevention Trial Risk Calculator 2.0 model and standard of care (biopsy for all men) according to DCA.
A possible reduction of 30–58% in the number biopsies was identified with delayed diagnosis in only 1.3–4.7% of Gleason ≥ 7 PCa cases, depending on the threshold used for biopsy.
Pathological assessment was performed according to the standard of care at each site without centralized review.
