Individualized prostate-specific antigen threshold values to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy in elderly men

Kent Kanao, Osamu Komori, Jun Nakashima, Takashi Ohigashi, Eiji Kikuchi, Akira Miyajima, Ken Nakagawa, Shinto Eguchi, Mototsugu Oya

研究成果: Article

抄録

Objective: To individualize prostate-specific antigen threshold values to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy in elderly men. Methods: A total of 406 men aged over 70 years old with prostate-specific antigen levels between 4.0 and 20.0 ng/ml, normal digital rectal examination results and diagnosed by transrectal needle biopsy were retrospectively analyzed. The patients were divided into a no/favorable-risk cancer group or an unfavorable-risk cancer group based on their Gleason score and the number of positive cores. Prostate-specific antigen levels, percent free prostate specific antigen level, prostate transition zone volume and the number of previous biopsies were used to discriminate between the two groups.The optimal individualized prostate-specific antigen threshold values based on the other variables that gave a sensitivity of 95% for the detection of unfavorable-risk cancer were calculated using a boosting method for maximizing the area under the receiver operating characteristic curve. Results: A total of 66 men had favorable-risk cancer, and 139 had unfavorable-risk cancer. The area under the receiver operating characteristic curve of the combination model determined by the boosting method for maximizing the area under the receiver operating characteristic curve was 0.852. The sensitivity and specificity of the threshold values for the detection of unfavorable-risk cancer were 95 and 36%, respectively. By using the threshold values, 100 (25%) of the subjects with no/favorable-risk cancer could have avoided undergoing biopsies, with a <5% risk of missing the detection of unfavorable-risk cancer. Conclusions: These individualized prostate-specific antigen threshold values may be useful for determining an indication of prostate biopsy for elderly men to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy.

元の言語English
ページ(範囲)852-859
ページ数8
ジャーナルJapanese Journal of Clinical Oncology
44
発行部数9
DOI
出版物ステータスPublished - 2014

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Prostate-Specific Antigen
Prostatic Neoplasms
Biopsy
Neoplasms
ROC Curve
Prostate
Medical Overuse
Digital Rectal Examination
Neoplasm Grading
Needle Biopsy
Sensitivity and Specificity

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

これを引用

Individualized prostate-specific antigen threshold values to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy in elderly men. / Kanao, Kent; Komori, Osamu; Nakashima, Jun; Ohigashi, Takashi; Kikuchi, Eiji; Miyajima, Akira; Nakagawa, Ken; Eguchi, Shinto; Oya, Mototsugu.

:: Japanese Journal of Clinical Oncology, 巻 44, 番号 9, 2014, p. 852-859.

研究成果: Article

Kanao, Kent ; Komori, Osamu ; Nakashima, Jun ; Ohigashi, Takashi ; Kikuchi, Eiji ; Miyajima, Akira ; Nakagawa, Ken ; Eguchi, Shinto ; Oya, Mototsugu. / Individualized prostate-specific antigen threshold values to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy in elderly men. :: Japanese Journal of Clinical Oncology. 2014 ; 巻 44, 番号 9. pp. 852-859.
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abstract = "Objective: To individualize prostate-specific antigen threshold values to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy in elderly men. Methods: A total of 406 men aged over 70 years old with prostate-specific antigen levels between 4.0 and 20.0 ng/ml, normal digital rectal examination results and diagnosed by transrectal needle biopsy were retrospectively analyzed. The patients were divided into a no/favorable-risk cancer group or an unfavorable-risk cancer group based on their Gleason score and the number of positive cores. Prostate-specific antigen levels, percent free prostate specific antigen level, prostate transition zone volume and the number of previous biopsies were used to discriminate between the two groups.The optimal individualized prostate-specific antigen threshold values based on the other variables that gave a sensitivity of 95{\%} for the detection of unfavorable-risk cancer were calculated using a boosting method for maximizing the area under the receiver operating characteristic curve. Results: A total of 66 men had favorable-risk cancer, and 139 had unfavorable-risk cancer. The area under the receiver operating characteristic curve of the combination model determined by the boosting method for maximizing the area under the receiver operating characteristic curve was 0.852. The sensitivity and specificity of the threshold values for the detection of unfavorable-risk cancer were 95 and 36{\%}, respectively. By using the threshold values, 100 (25{\%}) of the subjects with no/favorable-risk cancer could have avoided undergoing biopsies, with a <5{\%} risk of missing the detection of unfavorable-risk cancer. Conclusions: These individualized prostate-specific antigen threshold values may be useful for determining an indication of prostate biopsy for elderly men to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy.",
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T1 - Individualized prostate-specific antigen threshold values to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy in elderly men

AU - Kanao, Kent

AU - Komori, Osamu

AU - Nakashima, Jun

AU - Ohigashi, Takashi

AU - Kikuchi, Eiji

AU - Miyajima, Akira

AU - Nakagawa, Ken

AU - Eguchi, Shinto

AU - Oya, Mototsugu

PY - 2014

Y1 - 2014

N2 - Objective: To individualize prostate-specific antigen threshold values to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy in elderly men. Methods: A total of 406 men aged over 70 years old with prostate-specific antigen levels between 4.0 and 20.0 ng/ml, normal digital rectal examination results and diagnosed by transrectal needle biopsy were retrospectively analyzed. The patients were divided into a no/favorable-risk cancer group or an unfavorable-risk cancer group based on their Gleason score and the number of positive cores. Prostate-specific antigen levels, percent free prostate specific antigen level, prostate transition zone volume and the number of previous biopsies were used to discriminate between the two groups.The optimal individualized prostate-specific antigen threshold values based on the other variables that gave a sensitivity of 95% for the detection of unfavorable-risk cancer were calculated using a boosting method for maximizing the area under the receiver operating characteristic curve. Results: A total of 66 men had favorable-risk cancer, and 139 had unfavorable-risk cancer. The area under the receiver operating characteristic curve of the combination model determined by the boosting method for maximizing the area under the receiver operating characteristic curve was 0.852. The sensitivity and specificity of the threshold values for the detection of unfavorable-risk cancer were 95 and 36%, respectively. By using the threshold values, 100 (25%) of the subjects with no/favorable-risk cancer could have avoided undergoing biopsies, with a <5% risk of missing the detection of unfavorable-risk cancer. Conclusions: These individualized prostate-specific antigen threshold values may be useful for determining an indication of prostate biopsy for elderly men to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy.

AB - Objective: To individualize prostate-specific antigen threshold values to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy in elderly men. Methods: A total of 406 men aged over 70 years old with prostate-specific antigen levels between 4.0 and 20.0 ng/ml, normal digital rectal examination results and diagnosed by transrectal needle biopsy were retrospectively analyzed. The patients were divided into a no/favorable-risk cancer group or an unfavorable-risk cancer group based on their Gleason score and the number of positive cores. Prostate-specific antigen levels, percent free prostate specific antigen level, prostate transition zone volume and the number of previous biopsies were used to discriminate between the two groups.The optimal individualized prostate-specific antigen threshold values based on the other variables that gave a sensitivity of 95% for the detection of unfavorable-risk cancer were calculated using a boosting method for maximizing the area under the receiver operating characteristic curve. Results: A total of 66 men had favorable-risk cancer, and 139 had unfavorable-risk cancer. The area under the receiver operating characteristic curve of the combination model determined by the boosting method for maximizing the area under the receiver operating characteristic curve was 0.852. The sensitivity and specificity of the threshold values for the detection of unfavorable-risk cancer were 95 and 36%, respectively. By using the threshold values, 100 (25%) of the subjects with no/favorable-risk cancer could have avoided undergoing biopsies, with a <5% risk of missing the detection of unfavorable-risk cancer. Conclusions: These individualized prostate-specific antigen threshold values may be useful for determining an indication of prostate biopsy for elderly men to avoid overdiagnosis of prostate cancer and reduce unnecessary biopsy.

KW - Elderly

KW - Individualized threshold values

KW - Overdiagnosis

KW - Prostate cancer

KW - Prostate-specific antigen

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DO - 10.1093/jjco/hyu084

M3 - Article

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JO - Japanese Journal of Clinical Oncology

JF - Japanese Journal of Clinical Oncology

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