MP86-15 CREATION OF THE TORONTO BIOPSY AVOIDANCE TOOLS (T-BAT) WITH CLINICAL PARAMETER-ONLY AND ADIPOKINE BIOMARKER-AUGMENTED VERSIONS

Le résumé fourni par la source

You have accessJournal of UrologyProstate Cancer: Detection and Screening VII1 Apr 2015MP86-15 CREATION OF THE TORONTO BIOPSY AVOIDANCE TOOLS (T-BAT) WITH CLINICAL PARAMETER-ONLY AND ADIPOKINE BIOMARKER-AUGMENTED VERSIONS Bimal Bhindi, Aza Mohammed, Haiyan Jiang, Robert Hamilton, Ants Toi, Antonio Finelli, John Trachtenberg, Alexandre Zlotta, Theodorus van der Kwast, Andrew Evans, Neil Fleshner, and Girish Kulkarni Bimal BhindiBimal Bhindi More articles by this author , Aza MohammedAza Mohammed More articles by this author , Haiyan JiangHaiyan Jiang More articles by this author , Robert HamiltonRobert Hamilton More articles by this author , Ants ToiAnts Toi More articles by this author , Antonio FinelliAntonio Finelli More articles by this author , John TrachtenbergJohn Trachtenberg More articles by this author , Alexandre ZlottaAlexandre Zlotta More articles by this author , Theodorus van der KwastTheodorus van der Kwast More articles by this author , Andrew EvansAndrew Evans More articles by this author , Neil FleshnerNeil Fleshner More articles by this author , and Girish KulkarniGirish Kulkarni More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1924AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Concerns have been raised regarding the over-diagnosis of prostate cancer (PC) and biopsy-related complications. In order to guide clinicians in deciding when biopsy can be deferred/avoided, our aim was to create a tool using clinical predictors and adipokine biomarkers to predict the probability of low risk PC or negative biopsy (i.e. where intervention is not likely needed) among men undergoing either first or repeat biopsy. METHODS Separate models were created for men undergoing first biopsy (men identified using our institutional BioBank) versus repeat biopsy (men identified from REDUCE trial). Among men undergoing first biopsy, clinical variables considered for model inclusion were age, abnormal DRE, PSA, family history of PC, ethnicity, and BMI. For repeat biopsy, change in DRE, change in PSA, free PSA, presence of HGPIN or ASAP on prior biopsy, number of prior biopsies, number of cores previously taken and prostate volume (PV) were additionally considered. Adipokines studied included resistin, tumor necrosis factor alpha, interleukin -6 (IL-6), nerve growth factor (NGF), hepatocyte growth factor and monocyte chemoattractant protein–1. The primary outcome was a composite of negative biopsy or low risk PC (no Gleason pattern ≥4, ≤3 positive cores, and no core with >50% cancer involvement). Multivariable logistic regression models that minimized mean squared error and maximized out-of-sample area under the receiver operating characteristics curve (AUC) were chosen. Clinical parameter-only versions of models were also created to allow for more widespread use. RESULTS In our study of 2270 men (1061 from BioBank, 1209 from REDUCE), 445 (365 (34.4%) from BioBank, 80 (6.7%) from REDUCE) had non-low risk PC. Age, PSA, DRE, family history, ethnicity and IL-6 were selected for the model for first biopsy. Age, PSA, PSA change, prior biopsy with HGPIN, number of biopsy cores previously taken, PV, IL-6 and NGF were selected for the model for repeat biopsy. The out-of-sample AUC for the models for first and repeat biopsy were 0.75 (95%CI=0.72-0.78) and 0.78 (95%CI=0.73-0.83), respectively. CONCLUSIONS Models predicting probability of either negative biopsy or low risk PC (i.e. no intervention needed) in men undergoing first and repeat biopsy were successfully created. Predictive value of each variable was different in each instance. These models may guide clinicians in using biopsy more judiciously. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1081 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Metrics Author Information Bimal Bhindi More articles by this author Aza Mohammed More articles by this author Haiyan Jiang More articles by this author Robert Hamilton More articles by this author Ants Toi More articles by this author Antonio Finelli More articles by this author John Trachtenberg More articles by this author Alexandre Zlotta More articles by this author Theodorus van der Kwast More articles by this author Andrew Evans More articles by this author Neil Fleshner More articles by this author Girish Kulkarni More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.