Validation of a nomogram for predicting positive repeat biopsy for prostate cancer Journal Article


Authors: Yanke, B. V.; Gonen, M.; Scardino, P. T.; Kattan, M. W.
Article Title: Validation of a nomogram for predicting positive repeat biopsy for prostate cancer
Abstract: Purpose: We reported a nomogram and subsequently a corrected version for predicting the probability of positive biopsy in men with 1 or more prior negative biopsies. In this study we assessed the validity of this nomogram when applied to an external dataset. Materials and Methods: There were 230 patients from the Brooklyn Veterans Administration Medical Center who underwent 1 or more repeat biopsies after initial negative biopsy from January 1993 to June 2003. Predictor variables studied in the nomogram were patient age, family history of prostate cancer, digital rectal examination, serum prostate specific antigen, prostate specific antigen slope, months from initial negative biopsy session, months from previous negative biopsy session, cumulative number of negative cores previously taken and history of high grade intraepithelial neoplasm or atypical small acinar proliferation. We calculated the nomogram predicted probability in each patient. These predicted outcomes were compared with actual biopsy results. Area under the ROC curve was calculated as a measure of discrimination. Calibration was assessed graphically. Results: We evaluated a total of 356 repeat biopsies in 230 patients (mean 2.56 total biopsies per patient). The mean number of total cores per patient was 17.9. There were 78 positive biopsies. The area under the ROC curve was 0.71, which was greater than any single risk factor. Nomogram calibration appeared to be good. Conclusions: Our corrected nomogram for predicting positive repeat biopsy performed well when applied to a sample of men at the Brooklyn Veterans Administration Medical Center. This nomogram can provide important additional information to aid the urologist and patient with a negative biopsy in evaluating clinical options.
Keywords: adult; controlled study; aged; aged, 80 and over; middle aged; validation process; cell proliferation; reproducibility of results; tumor biopsy; prediction; risk factor; biopsy; prostate cancer; prostatic neoplasms; prostate; nomograms; family history; prostate biopsy; urology; predictive value of tests; outcomes research; physical examination; nomogram; acinar cell
Journal Title: Journal of Urology
Volume: 173
Issue: 2
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2005-02-01
Start Page: 421
End Page: 424
Language: English
DOI: 10.1097/01.ju.0000150522.82760.00
PUBMED: 15643192
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 42" - "Export Date: 24 October 2012" - "CODEN: JOURA" - "Source: Scopus"
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MSK Authors
  1. Peter T Scardino
    671 Scardino
  2. Mithat Gonen
    1028 Gonen
  3. Michael W Kattan
    218 Kattan