External validation of the Rotterdam prostate cancer risk calculator within a high-risk Dutch clinical cohort

Marinus J. Hagens; Piter J. Stelwagen; Hans Veerman; Sybren P. Rynja; Martijn Smeenge; Vincent van der Noort; Ton A. Roeleveld; Jolien van Kesteren; Sebastiaan Remmers; Monique J. Roobol; Pim J. van Leeuwen; Henk G. van der Poel

doi:https://doi.org/10.1007/s00345-022-04185-y

External validation of the Rotterdam prostate cancer risk calculator within a high-risk Dutch clinical cohort

Marinus J. Hagens, Piter J. Stelwagen, Hans Veerman, Sybren P. Rynja, Martijn Smeenge, Vincent van der Noort, Ton A. Roeleveld, Jolien van Kesteren, Sebastiaan Remmers, Monique J. Roobol, Pim J. van Leeuwen, Henk G. van der Poel

Urology (VUmc)

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Pages (from-to)	13-18
Number of pages	6
Journal	World Journal of Urology
Volume	41
Issue number	1
Early online date	2022
DOIs	https://doi.org/10.1007/s00345-022-04185-y
Publication status	Published - Jan 2023

Keywords

MRI
Prostate biopsies
Prostate cancer
Risk stratification

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Hagens, M. J., Stelwagen, P. J., Veerman, H., Rynja, S. P., Smeenge, M., van der Noort, V., Roeleveld, T. A., van Kesteren, J., Remmers, S., Roobol, M. J., van Leeuwen, P. J., & van der Poel, H. G. (2023). External validation of the Rotterdam prostate cancer risk calculator within a high-risk Dutch clinical cohort. World Journal of Urology, 41(1), 13-18. https://doi.org/10.1007/s00345-022-04185-y

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title = "External validation of the Rotterdam prostate cancer risk calculator within a high-risk Dutch clinical cohort",

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.",

keywords = "MRI, Prostate biopsies, Prostate cancer, Risk stratification",

author = "Hagens, {Marinus J.} and Stelwagen, {Piter J.} and Hans Veerman and Rynja, {Sybren P.} and Martijn Smeenge and {van der Noort}, Vincent and Roeleveld, {Ton A.} and {van Kesteren}, Jolien and Sebastiaan Remmers and Roobol, {Monique J.} and {van Leeuwen}, {Pim J.} and {van der Poel}, {Henk G.}",

note = "Publisher Copyright: {\textcopyright} 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.",

year = "2023",

month = jan,

doi = "https://doi.org/10.1007/s00345-022-04185-y",

language = "English",

volume = "41",

pages = "13--18",

journal = "World Journal of Urology",

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Hagens, MJ, Stelwagen, PJ, Veerman, H, Rynja, SP, Smeenge, M, van der Noort, V, Roeleveld, TA, van Kesteren, J, Remmers, S, Roobol, MJ, van Leeuwen, PJ & van der Poel, HG 2023, 'External validation of the Rotterdam prostate cancer risk calculator within a high-risk Dutch clinical cohort', World Journal of Urology, vol. 41, no. 1, pp. 13-18. https://doi.org/10.1007/s00345-022-04185-y

TY - JOUR

T1 - External validation of the Rotterdam prostate cancer risk calculator within a high-risk Dutch clinical cohort

AU - Hagens, Marinus J.

AU - Stelwagen, Piter J.

AU - Veerman, Hans

AU - Rynja, Sybren P.

AU - Smeenge, Martijn

AU - van der Noort, Vincent

AU - Roeleveld, Ton A.

AU - van Kesteren, Jolien

AU - Remmers, Sebastiaan

AU - Roobol, Monique J.

AU - van Leeuwen, Pim J.

AU - van der Poel, Henk G.

PY - 2023/1

Y1 - 2023/1

N2 - 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.

AB - 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.

KW - MRI

KW - Prostate biopsies

KW - Prostate cancer

KW - Risk stratification

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U2 - https://doi.org/10.1007/s00345-022-04185-y

DO - https://doi.org/10.1007/s00345-022-04185-y

M3 - Article

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SN - 0724-4983

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EP - 18

JO - World Journal of Urology

JF - World Journal of Urology

IS - 1

ER -

External validation of the Rotterdam prostate cancer risk calculator within a high-risk Dutch clinical cohort

Abstract

Keywords

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