Assessment of the ERSPC and PCPT2.0 risk calculators in the prediction of prostate cancer in men attending a prostate assessment clinic


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Sandesh Kc1,Thomas King2,David Mak2,Rupesh Bhatt2,Alan Doherty2,Richard Viney2,Prashant Patel2,Brian Kelly2

1University Hospital Birmingham,2UHB

Abstract

Background

To analyse and externally validate the ERSPC and PCPT Risk Calculators in the assessment of men with prostate cancer using the parameters of PSA, DRE, previous biopsy, family history, TRUS volume, ethnicity and TRUS findings.

Method

Data from all men who underwent prostate biopsy at an academic tertiary care centre between 2012 and 2016 were retrospectively analysed. The probability of having any prostate cancer or high grade prostate cancer (Gleason score 7 or greater) on prostate biopsy was calculated using the ERSPC and PCPT2.0 risk calculator. Performance was assessed using calibration and discrimination, and additionally compared with the PCPT2.0-RC and ERSPC-RC by decision curve analyses.

Results

The risk of cancer and risk of high grade cancer were calculated in a population of 1210 men. 766 were diagnosed with cancer and 444 had a benign histological finding. 47 men had a previous negative biopsy and 136 had a positive family history. 220 men had a Gleason score 6, 546 men had a gleason score of 7 or higher. Median PSA is 8.9 (0.1-5000). ROC curve for the ERSPC RC had an AUC of 0.671 and the PCPT2.0 RC had an AUC of 0.691 (p=0.0753). The ROC curve for high grade cancer (Gleason 7 or higher) for ERSPC had an AUC of 0.764 and the PCPT2.0 had an AUC 0.758 (p=0.4881). Decision curves were then plotting using the date for each respective risk calculator. Decision curve analysis identifies there is significant ability for these RC to correctly identify men with prostate cancer.

Conclusion

Individual patient risk calculation using the ERSPC and PCPT2.0 risk calculator can be undertaken in order to allow a systematic approach to patient risk stratification and to aid in the diagnosis of PCa and to identify who should and who should not undergo a prostate biopsy.