Risk score for detecting insignificant prostate cancer in unscreened patient cohorts
This risk score was developed to differentiate between insignificant and significant prostate cancer in patients with Gleason 3+3 or lower prostate cancer in the preoperative setting. It allows users to select the desired sensitivity and specificity levels for detecting insignificant prostate cancer using two different cut-offs:
 
  • Cut-off 1: By selecting this cut-off value the calculator will have a sensitivity and specificity of 90% and 41% in detecting insignificant cancer, respectively. This setting is aimed at reducing the risk of over-treatment as much as possible (improved detection of true positive results).
 
  • Cut-off 2: By selecting this cut-off value the calculator will have a sensitivity and specificity of 38% and 90% in detecting insignificant cancer, respectively. This setting is aimed at reducing the risk of missing a significant PCa as much as possible (improved detection of true negative results).
Research authors: Dutto L, Ahmad A, Urbanova K, Wagner C, Schuette A, Addali M, Kelly JD, Shridhar A, Nathan S, Briggs TP, Witt JH, Shaw G
Details Custom formula Study characteristics Files & References
★★★★
Model author
Model ID
1391
Version
1.113
Revision date
2018-12-05
Specialty
MeSH terms
  • Prostate Cancer
  • Decision Support Model
  • Model type
    Custom model (Calculation)
    Status
    public
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    Formula

    Additional information

    Study population: 
    Data was obtained from 8040 consecutive unscreened patients who underwent radical robotic prostatectomy (RARP) at a German tertiary referral centre between February 2006 and January 2016. Prospectively collected data was available for 7797 patients. Amongst these, 3808 patients were identified who had been diagnosed with Gleason 3+3 prostate cancer.

    Exclusion criteria:
    Of 3808 included patients, 308 that had been diagnosed via MRI-based fusion biopsy were excluded, as the different sampling method may act as a possible confounder. Further 701 patients were excluded for missing data on tumour volume on pathology. The remaining 2799 patients were included for final analysis.

    Development of risk score:
    Patients’ pathology findings after prostatectomy were stratified according to the updated ERSPC prostate cancer risk criteria and were used to develop a novel risk score (derivation cohort). The validation cohort consisted of 430 unscreened men who underwent RARP for Gleason 3+3 prostate cancer in two tertiary referral centres in the UK and for whom the same clinical data as the derivation cohort was available.

    Study Population

    Total population size: 2799
    Males: {{ model.numberOfMales }}
    Females: {{ model.numberOfFemales }}

    Categorical characteristics

    Name Subset / Group Nr. of patients
    PCa risk stratification High risk 295
    Intermediate risk 651
    Low risk 1853
    Stage on DRE cT1a 8
    cT1b 1
    cT1c 1996
    cT2a 410
    cT2b 243
    cT2c 141

    Relative odds of having insignificant PCa, compared to study population:
    ...

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    Result
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    Relative odds of having insignificant PCa, compared to study population:

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    Outcome stratification

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    Conditional information

    Result interpretation

    Risk score based on: Dutto L, Ahmad A, Urbanova K, et al. Development and validation of a novel risk score for the detection of insignificant prostate cancer in unscreened patient cohorts. Br J Cancer. 2018 Nov 27. [Epub ahead of print]

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    Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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