External validation of the Rotterdam prostate cancer risk calculator within a high-risk Dutch clinical cohort
Purpose This study aims to externally validate the Rotterdam Prostate Cancer Risk Calculator (RPCRC)-3/4 and RPCRC-MRI within a Dutch clinical cohort. Methods Men subjected to prostate biopsies, between 2018 and 2021, due to a clinical suspicion of prostate cancer (PCa) were retrospectively included...
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| Veröffentlicht in: | World journal of urology 2023-01, Vol.41 (1), p.13-18 |
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| creator | Hagens, Marinus J. Stelwagen, Piter J. Veerman, Hans Rynja, Sybren P. Smeenge, Martijn van der Noort, Vincent Roeleveld, Ton A. van Kesteren, Jolien Remmers, Sebastiaan Roobol, Monique J. van Leeuwen, Pim J. van der Poel, Henk G. |
| description | Purpose
This study aims to externally validate the Rotterdam Prostate Cancer Risk Calculator (RPCRC)-3/4 and RPCRC-MRI within a Dutch clinical cohort.
Methods
Men subjected to prostate biopsies, between 2018 and 2021, due to a clinical suspicion of prostate cancer (PCa) were retrospectively included. The performance of the RPCRC-3/4 and RPCRC-MRI was analyzed in terms of discrimination, calibration and net benefit. In addition, the need for recalibration and adjustment of risk thresholds for referral was investigated. Clinically significant (cs) PCa was defined as Gleason score ≥ 3 + 4.
Results
A total of 1575 men were included in the analysis. PCa was diagnosed in 63.2% (996/1575) of men and csPCa in 41.7% (656/1575) of men. Use of the RPCRC-3/4 could have prevented 37.3% (587/1575) of all MRIs within this cohort, thereby missing 18.3% (120/656) of csPCa diagnoses. After recalibration and adjustment of risk thresholds to 20% for PCa and 10% for csPCa, use of the recalibrated RPCRC-3/4 could have prevented 15.1% (238/1575) of all MRIs, resulting in 5.3% (35/656) of csPCa diagnoses being missed. The performance of the RPCRC-MRI was good; use of this risk calculator could have prevented 10.7% (169/1575) of all biopsies, resulting in 1.2% (8/656) of csPCa diagnoses being missed.
Conclusion
The RPCRC-3/4 underestimates the probability of having csPCa within this Dutch clinical cohort, resulting in significant numbers of csPCa diagnoses being missed. For optimal performance of a risk calculator in a specific cohort, evaluation of its performance within the population under study is essential. |
| doi_str_mv | 10.1007/s00345-022-04185-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2725439814</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2766574356</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-ea4c8d7efe24aae7d854f305fc58c02a05dd4f358c7fd01410807df3df17b8ee3</originalsourceid><addsrcrecordid>eNp9kUtv1TAQhS0Eou2FP8ACWWLDJnT8isMSlVKQKlVCsLZce9y4JHGxHeD--_r2loe6YOWx55sz1jmEvGDwhgHo4wIgpOqA8w4kG1S3fUQOmRSiGzTvH_9TH5CjUq4BmO5BPSUHoudSAVOHZD79VTEvdqI_7BS9rTEtNAVaR6SfU209b2d6k1OptiJ1dnGYaY7lW6snt062pkx_xjrGhVo6xquxu-u-X6sbqZviEhtIXRpTrs_Ik2Cngs_vzw35-uH0y8nH7vzi7NPJu_POCa1qh1a6wWsMyKW1qP2gZBCgglODA25Bed8e2kUHD0wyGED7IHxg-nJAFBvyeq_bPv59xVLNHIvDabILprUYrrmS4u3QDNqQVw_Q67TuDNlRfa-0FKpvFN9TrjlRMgZzk-Ns89YwMLswzD4M08Iwd2GYbRt6eS-9Xs7o_4z8dr8BYg-U1lquMP_d_R_ZW1u2lvI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2766574356</pqid></control><display><type>article</type><title>External validation of the Rotterdam prostate cancer risk calculator within a high-risk Dutch clinical cohort</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Hagens, Marinus J. ; Stelwagen, Piter J. ; Veerman, Hans ; Rynja, Sybren P. ; Smeenge, Martijn ; van der Noort, Vincent ; Roeleveld, Ton A. ; van Kesteren, Jolien ; Remmers, Sebastiaan ; Roobol, Monique J. ; van Leeuwen, Pim J. ; van der Poel, Henk G.</creator><creatorcontrib>Hagens, Marinus J. ; Stelwagen, Piter J. ; Veerman, Hans ; Rynja, Sybren P. ; Smeenge, Martijn ; van der Noort, Vincent ; Roeleveld, Ton A. ; van Kesteren, Jolien ; Remmers, Sebastiaan ; Roobol, Monique J. ; van Leeuwen, Pim J. ; van der Poel, Henk G.</creatorcontrib><description>Purpose
This study aims to externally validate the Rotterdam Prostate Cancer Risk Calculator (RPCRC)-3/4 and RPCRC-MRI within a Dutch clinical cohort.
Methods
Men subjected to prostate biopsies, between 2018 and 2021, due to a clinical suspicion of prostate cancer (PCa) were retrospectively included. The performance of the RPCRC-3/4 and RPCRC-MRI was analyzed in terms of discrimination, calibration and net benefit. In addition, the need for recalibration and adjustment of risk thresholds for referral was investigated. Clinically significant (cs) PCa was defined as Gleason score ≥ 3 + 4.
Results
A total of 1575 men were included in the analysis. PCa was diagnosed in 63.2% (996/1575) of men and csPCa in 41.7% (656/1575) of men. Use of the RPCRC-3/4 could have prevented 37.3% (587/1575) of all MRIs within this cohort, thereby missing 18.3% (120/656) of csPCa diagnoses. After recalibration and adjustment of risk thresholds to 20% for PCa and 10% for csPCa, use of the recalibrated RPCRC-3/4 could have prevented 15.1% (238/1575) of all MRIs, resulting in 5.3% (35/656) of csPCa diagnoses being missed. The performance of the RPCRC-MRI was good; use of this risk calculator could have prevented 10.7% (169/1575) of all biopsies, resulting in 1.2% (8/656) of csPCa diagnoses being missed.
Conclusion
The RPCRC-3/4 underestimates the probability of having csPCa within this Dutch clinical cohort, resulting in significant numbers of csPCa diagnoses being missed. For optimal performance of a risk calculator in a specific cohort, evaluation of its performance within the population under study is essential.</description><identifier>ISSN: 1433-8726</identifier><identifier>ISSN: 0724-4983</identifier><identifier>EISSN: 1433-8726</identifier><identifier>DOI: 10.1007/s00345-022-04185-y</identifier><identifier>PMID: 36245015</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Biopsy ; Cohort analysis ; Humans ; Magnetic resonance imaging ; Male ; Medicine ; Medicine & Public Health ; Nephrology ; Oncology ; Original Article ; Population studies ; Prostate - pathology ; Prostate cancer ; Prostate-Specific Antigen ; Prostatic Neoplasms - diagnosis ; Prostatic Neoplasms - epidemiology ; Prostatic Neoplasms - pathology ; Retrospective Studies ; Risk Assessment - methods ; Urology</subject><ispartof>World journal of urology, 2023-01, Vol.41 (1), p.13-18</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-ea4c8d7efe24aae7d854f305fc58c02a05dd4f358c7fd01410807df3df17b8ee3</citedby><cites>FETCH-LOGICAL-c375t-ea4c8d7efe24aae7d854f305fc58c02a05dd4f358c7fd01410807df3df17b8ee3</cites><orcidid>0000-0001-6699-0201</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00345-022-04185-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00345-022-04185-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36245015$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hagens, Marinus J.</creatorcontrib><creatorcontrib>Stelwagen, Piter J.</creatorcontrib><creatorcontrib>Veerman, Hans</creatorcontrib><creatorcontrib>Rynja, Sybren P.</creatorcontrib><creatorcontrib>Smeenge, Martijn</creatorcontrib><creatorcontrib>van der Noort, Vincent</creatorcontrib><creatorcontrib>Roeleveld, Ton A.</creatorcontrib><creatorcontrib>van Kesteren, Jolien</creatorcontrib><creatorcontrib>Remmers, Sebastiaan</creatorcontrib><creatorcontrib>Roobol, Monique J.</creatorcontrib><creatorcontrib>van Leeuwen, Pim J.</creatorcontrib><creatorcontrib>van der Poel, Henk G.</creatorcontrib><title>External validation of the Rotterdam prostate cancer risk calculator within a high-risk Dutch clinical cohort</title><title>World journal of urology</title><addtitle>World J Urol</addtitle><addtitle>World J Urol</addtitle><description>Purpose
This study aims to externally validate the Rotterdam Prostate Cancer Risk Calculator (RPCRC)-3/4 and RPCRC-MRI within a Dutch clinical cohort.
Methods
Men subjected to prostate biopsies, between 2018 and 2021, due to a clinical suspicion of prostate cancer (PCa) were retrospectively included. The performance of the RPCRC-3/4 and RPCRC-MRI was analyzed in terms of discrimination, calibration and net benefit. In addition, the need for recalibration and adjustment of risk thresholds for referral was investigated. Clinically significant (cs) PCa was defined as Gleason score ≥ 3 + 4.
Results
A total of 1575 men were included in the analysis. PCa was diagnosed in 63.2% (996/1575) of men and csPCa in 41.7% (656/1575) of men. Use of the RPCRC-3/4 could have prevented 37.3% (587/1575) of all MRIs within this cohort, thereby missing 18.3% (120/656) of csPCa diagnoses. After recalibration and adjustment of risk thresholds to 20% for PCa and 10% for csPCa, use of the recalibrated RPCRC-3/4 could have prevented 15.1% (238/1575) of all MRIs, resulting in 5.3% (35/656) of csPCa diagnoses being missed. The performance of the RPCRC-MRI was good; use of this risk calculator could have prevented 10.7% (169/1575) of all biopsies, resulting in 1.2% (8/656) of csPCa diagnoses being missed.
Conclusion
The RPCRC-3/4 underestimates the probability of having csPCa within this Dutch clinical cohort, resulting in significant numbers of csPCa diagnoses being missed. For optimal performance of a risk calculator in a specific cohort, evaluation of its performance within the population under study is essential.</description><subject>Biopsy</subject><subject>Cohort analysis</subject><subject>Humans</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nephrology</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Population studies</subject><subject>Prostate - pathology</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen</subject><subject>Prostatic Neoplasms - diagnosis</subject><subject>Prostatic Neoplasms - epidemiology</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Retrospective Studies</subject><subject>Risk Assessment - methods</subject><subject>Urology</subject><issn>1433-8726</issn><issn>0724-4983</issn><issn>1433-8726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kUtv1TAQhS0Eou2FP8ACWWLDJnT8isMSlVKQKlVCsLZce9y4JHGxHeD--_r2loe6YOWx55sz1jmEvGDwhgHo4wIgpOqA8w4kG1S3fUQOmRSiGzTvH_9TH5CjUq4BmO5BPSUHoudSAVOHZD79VTEvdqI_7BS9rTEtNAVaR6SfU209b2d6k1OptiJ1dnGYaY7lW6snt062pkx_xjrGhVo6xquxu-u-X6sbqZviEhtIXRpTrs_Ik2Cngs_vzw35-uH0y8nH7vzi7NPJu_POCa1qh1a6wWsMyKW1qP2gZBCgglODA25Bed8e2kUHD0wyGED7IHxg-nJAFBvyeq_bPv59xVLNHIvDabILprUYrrmS4u3QDNqQVw_Q67TuDNlRfa-0FKpvFN9TrjlRMgZzk-Ns89YwMLswzD4M08Iwd2GYbRt6eS-9Xs7o_4z8dr8BYg-U1lquMP_d_R_ZW1u2lvI</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Hagens, Marinus J.</creator><creator>Stelwagen, Piter J.</creator><creator>Veerman, Hans</creator><creator>Rynja, Sybren P.</creator><creator>Smeenge, Martijn</creator><creator>van der Noort, Vincent</creator><creator>Roeleveld, Ton A.</creator><creator>van Kesteren, Jolien</creator><creator>Remmers, Sebastiaan</creator><creator>Roobol, Monique J.</creator><creator>van Leeuwen, Pim J.</creator><creator>van der Poel, Henk G.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><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>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6699-0201</orcidid></search><sort><creationdate>20230101</creationdate><title>External validation of the Rotterdam prostate cancer risk calculator within a high-risk Dutch clinical cohort</title><author>Hagens, Marinus J. ; Stelwagen, Piter J. ; Veerman, Hans ; Rynja, Sybren P. ; Smeenge, Martijn ; van der Noort, Vincent ; Roeleveld, Ton A. ; van Kesteren, Jolien ; Remmers, Sebastiaan ; Roobol, Monique J. ; van Leeuwen, Pim J. ; van der Poel, Henk G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-ea4c8d7efe24aae7d854f305fc58c02a05dd4f358c7fd01410807df3df17b8ee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Biopsy</topic><topic>Cohort analysis</topic><topic>Humans</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrology</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Population studies</topic><topic>Prostate - pathology</topic><topic>Prostate cancer</topic><topic>Prostate-Specific Antigen</topic><topic>Prostatic Neoplasms - diagnosis</topic><topic>Prostatic Neoplasms - epidemiology</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Retrospective Studies</topic><topic>Risk Assessment - methods</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hagens, Marinus J.</creatorcontrib><creatorcontrib>Stelwagen, Piter J.</creatorcontrib><creatorcontrib>Veerman, Hans</creatorcontrib><creatorcontrib>Rynja, Sybren P.</creatorcontrib><creatorcontrib>Smeenge, Martijn</creatorcontrib><creatorcontrib>van der Noort, Vincent</creatorcontrib><creatorcontrib>Roeleveld, Ton A.</creatorcontrib><creatorcontrib>van Kesteren, Jolien</creatorcontrib><creatorcontrib>Remmers, Sebastiaan</creatorcontrib><creatorcontrib>Roobol, Monique J.</creatorcontrib><creatorcontrib>van Leeuwen, Pim J.</creatorcontrib><creatorcontrib>van der Poel, Henk G.</creatorcontrib><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>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma 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 Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical 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><jtitle>World journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hagens, Marinus J.</au><au>Stelwagen, Piter J.</au><au>Veerman, Hans</au><au>Rynja, Sybren P.</au><au>Smeenge, Martijn</au><au>van der Noort, Vincent</au><au>Roeleveld, Ton A.</au><au>van Kesteren, Jolien</au><au>Remmers, Sebastiaan</au><au>Roobol, Monique J.</au><au>van Leeuwen, Pim J.</au><au>van der Poel, Henk G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>External validation of the Rotterdam prostate cancer risk calculator within a high-risk Dutch clinical cohort</atitle><jtitle>World journal of urology</jtitle><stitle>World J Urol</stitle><addtitle>World J Urol</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>41</volume><issue>1</issue><spage>13</spage><epage>18</epage><pages>13-18</pages><issn>1433-8726</issn><issn>0724-4983</issn><eissn>1433-8726</eissn><abstract>Purpose
This study aims to externally validate the Rotterdam Prostate Cancer Risk Calculator (RPCRC)-3/4 and RPCRC-MRI within a Dutch clinical cohort.
Methods
Men subjected to prostate biopsies, between 2018 and 2021, due to a clinical suspicion of prostate cancer (PCa) were retrospectively included. The performance of the RPCRC-3/4 and RPCRC-MRI was analyzed in terms of discrimination, calibration and net benefit. In addition, the need for recalibration and adjustment of risk thresholds for referral was investigated. Clinically significant (cs) PCa was defined as Gleason score ≥ 3 + 4.
Results
A total of 1575 men were included in the analysis. PCa was diagnosed in 63.2% (996/1575) of men and csPCa in 41.7% (656/1575) of men. Use of the RPCRC-3/4 could have prevented 37.3% (587/1575) of all MRIs within this cohort, thereby missing 18.3% (120/656) of csPCa diagnoses. After recalibration and adjustment of risk thresholds to 20% for PCa and 10% for csPCa, use of the recalibrated RPCRC-3/4 could have prevented 15.1% (238/1575) of all MRIs, resulting in 5.3% (35/656) of csPCa diagnoses being missed. The performance of the RPCRC-MRI was good; use of this risk calculator could have prevented 10.7% (169/1575) of all biopsies, resulting in 1.2% (8/656) of csPCa diagnoses being missed.
Conclusion
The RPCRC-3/4 underestimates the probability of having csPCa within this Dutch clinical cohort, resulting in significant numbers of csPCa diagnoses being missed. For optimal performance of a risk calculator in a specific cohort, evaluation of its performance within the population under study is essential.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36245015</pmid><doi>10.1007/s00345-022-04185-y</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-6699-0201</orcidid></addata></record> |
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| subjects | Biopsy Cohort analysis Humans Magnetic resonance imaging Male Medicine Medicine & Public Health Nephrology Oncology Original Article Population studies Prostate - pathology Prostate cancer Prostate-Specific Antigen Prostatic Neoplasms - diagnosis Prostatic Neoplasms - epidemiology Prostatic Neoplasms - pathology Retrospective Studies Risk Assessment - methods Urology |
| title | External validation of the Rotterdam prostate cancer risk calculator within a high-risk Dutch clinical cohort |
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