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KMID : 1001020090070010016
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Journal of Urologic Oncology
2009 Volume.7 No. 1 p.16 ~ p.20
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Application of ’CHIBA Program’ to Predict Probability of Positive Prostate Biopsy in Korean
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Kim Jung-Man
Chung Moon-Kee
Lee Chang-Yell
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Abstract
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Purpose: Because the incidence of prostate cancer is low among Asian, nomograms for prostate cancer detection based on the data of Western populations cannot be directly applied. The nomogram developed in Japan was applied to the data of Korean to compare the results between Korea and Japan.
Materials and Methods: Data were collected from 702 Korean male referrals who underwent initial prostate biopsies from January, 2000 to Febuary, 2006 in our Hospital. Among them, total 536 patients whose data were sufficient were applied to the new model. We analyzed age, total prostate-specific antigen (PSA) level, free/total PSA (f/t PSA) ratio, prostate volume, and digital rectal examination findings. Logistic regression analysis estimated relative risk, 95% confidence intervals, and p-values.
Results: Prostate cancer was detected in 193 (36.0%) of 536 patients’ biopsy specimens. Independent predictors of a positive biopsy result included elevated PSA levels, advanced age, small prostate volume, and abnormal digital rectal examination findings, but f/t PSA ratio was not a significant predictor. The area under the receiver operating characteristic curve for the new model was 85.9%, which was greater than that of the prediction based on PSA alone (area under the receiver operating characteristic curve 77.6%). If externally validated, applying this model could reduce the overall need for prostate biopsy by 14.3%.
Conclusions: Nomogram which was developed in Japan also improves the prediction of prostate cancer compared with predictions based on solely on the individual factors not only in Japanese but also in Korean. This study also shows that a nomogram may have different power to predict in a different patient cohort.
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KEYWORD
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Prostatic neoplasms, Nomogram, Biospy
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