Yonsei Med J.  2013 May;54(3):665-671. 10.3349/ymj.2013.54.3.665.

Can Western Based Online Prostate Cancer Risk Calculators Be Used to Predict Prostate Cancer after Prostate Biopsy for the Korean Population?

• Lee DH
• Jung HB
• Park JW
• Kim KH
• Kim J
• Lee SH
• Chung BH

• KMID: 1727880
• DOI: http://doi.org/10.3349/ymj.2013.54.3.665

Abstract

PURPOSE
To access the predictive value of the European Randomized Screening of Prostate Cancer Risk Calculator (ERSPC-RC) and the Prostate Cancer Prevention Trial Risk Calculator (PCPT-RC) in the Korean population.
MATERIALS AND METHODS
We retrospectively analyzed the data of 517 men who underwent transrectal ultrasound guided prostate biopsy between January 2008 and November 2010. Simple and multiple logistic regression analysis were performed to compare the result of prostate biopsy. Area under the receiver operating characteristics curves (AUC-ROC) and calibration plots were prepared for further analysis to compare the risk calculators and other clinical variables.
RESULTS
Prostate cancer was diagnosed in 125 (24.1%) men. For prostate cancer prediction, the area under curve (AUC) of the ERSPC-RC was 77.4%. This result was significantly greater than the AUCs of the PCPT-RC and the prostate-specific antigen (PSA) (64.5% and 64.1%, respectively, p<0.01), but not significantly different from the AUC of the PSA density (PSAD) (76.1%, p=0.540). When the results of the calibration plots were compared, the ERSPC-RC plot was more constant than that of PSAD.
CONCLUSION
The ERSPC-RC was better than PCPT-RC and PSA in predicting prostate cancer risk in the present study. However, the difference in performance between the ERSPC-RC and PSAD was not significant. Therefore, the Western based prostate cancer risk calculators are not useful for urologists in predicting prostate cancer in the Korean population.

Keyword

Korean; prostate cancer; biopsy; nomogram; validation study

MeSH Terms

Asian Continental Ancestry Group
Biopsy
*Diagnosis, Computer-Assisted
Early Detection of Cancer/*methods
Humans
Logistic Models
Male
Predictive Value of Tests
Prostatic Neoplasms/*diagnosis/ethnology/pathology
Republic of Korea/ethnology
Retrospective Studies
Risk Assessment/*methods

Figure

• 

  Fig. 1 Receiving operating characteristics curves for the ERSPC-RC, the PCPT-RC, PSA, and PSAD for (A) the total patient group, (B) the group with PSA >4.0 ng/mL, (C) the group with PSAD >0.15. ERSPC-RC, European Randomized Screening of Prostate Cancer Risk Calculator; PCPT-RC, Prostate Cancer Prevention Trial Risk Calculator; PSA, prostate-specific antigen; PSAD, PSA density.

• 

  Fig. 2 Calibration plot between predicted and observed probabilities of positive biopsy in the total cohort. ERSPC, European Randomized Screening of Prostate Cancer; PCPT, Prostate Cancer Prevention Trial; PSA, prostate-specific antigen; PSAD, PSA density.

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