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Development and External Validation of the STRATified CANcer Surveillance (STRATCANS) Multivariable Model for Predicting Progression in Men with Newly Diagnosed Prostate Cancer Starting Active Surveillance

For men with newly diagnosed prostate cancer, we aimed to develop and validate a model to predict the risk of progression on active surveillance (AS), which could inform more personalised AS strategies. In total, 883 men from 3 European centres were used for model development and internal validation...

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Autores principales: Light, Alexander, Lophatananon, Artitaya, Keates, Alexandra, Thankappannair, Vineetha, Barrett, Tristan, Dominguez-Escrig, Jose, Rubio-Briones, Jose, Benheddi, Toufik, Olivier, Jonathan, Villers, Arnauld, Babureddy, Kirthana, Abdelmoteleb, Haitham, Gnanapragasam, Vincent J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821695/
https://www.ncbi.nlm.nih.gov/pubmed/36615017
http://dx.doi.org/10.3390/jcm12010216
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author Light, Alexander
Lophatananon, Artitaya
Keates, Alexandra
Thankappannair, Vineetha
Barrett, Tristan
Dominguez-Escrig, Jose
Rubio-Briones, Jose
Benheddi, Toufik
Olivier, Jonathan
Villers, Arnauld
Babureddy, Kirthana
Abdelmoteleb, Haitham
Gnanapragasam, Vincent J.
author_facet Light, Alexander
Lophatananon, Artitaya
Keates, Alexandra
Thankappannair, Vineetha
Barrett, Tristan
Dominguez-Escrig, Jose
Rubio-Briones, Jose
Benheddi, Toufik
Olivier, Jonathan
Villers, Arnauld
Babureddy, Kirthana
Abdelmoteleb, Haitham
Gnanapragasam, Vincent J.
author_sort Light, Alexander
collection PubMed
description For men with newly diagnosed prostate cancer, we aimed to develop and validate a model to predict the risk of progression on active surveillance (AS), which could inform more personalised AS strategies. In total, 883 men from 3 European centres were used for model development and internal validation, and 151 men from a fourth European centre were used for external validation. Men with Cambridge Prognostic Group (CPG) 1–2 disease at diagnosis were eligible. The endpoint was progression to the composite endpoint of CPG3 disease or worse (≥CPG3). Model performance at 4 years was evaluated through discrimination (C-index), calibration plots, and decision curve analysis. The final multivariable model incorporated prostate-specific antigen (PSA), Grade Group, magnetic resonance imaging (MRI) score (Prostate Imaging Reporting & Data System (PI-RADS) or Likert), and prostate volume. Calibration and discrimination were good in both internal validation (C-index 0.742, 95% CI 0.694–0.793) and external validation (C-index 0.845, 95% CI 0.712–0.958). In decision curve analysis, the model offered net benefit compared to a ‘follow-all’ strategy at risk thresholds of ≥0.08 and ≥0.04 in development and external validation, respectively. In conclusion, our model demonstrated good accuracy and clinical utility in predicting the progression on AS at 4 years post-diagnosis. Men with lower risk predictions could subsequently be offered less-intense surveillance. Further external validation in larger cohorts is now required.
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spelling pubmed-98216952023-01-07 Development and External Validation of the STRATified CANcer Surveillance (STRATCANS) Multivariable Model for Predicting Progression in Men with Newly Diagnosed Prostate Cancer Starting Active Surveillance Light, Alexander Lophatananon, Artitaya Keates, Alexandra Thankappannair, Vineetha Barrett, Tristan Dominguez-Escrig, Jose Rubio-Briones, Jose Benheddi, Toufik Olivier, Jonathan Villers, Arnauld Babureddy, Kirthana Abdelmoteleb, Haitham Gnanapragasam, Vincent J. J Clin Med Article For men with newly diagnosed prostate cancer, we aimed to develop and validate a model to predict the risk of progression on active surveillance (AS), which could inform more personalised AS strategies. In total, 883 men from 3 European centres were used for model development and internal validation, and 151 men from a fourth European centre were used for external validation. Men with Cambridge Prognostic Group (CPG) 1–2 disease at diagnosis were eligible. The endpoint was progression to the composite endpoint of CPG3 disease or worse (≥CPG3). Model performance at 4 years was evaluated through discrimination (C-index), calibration plots, and decision curve analysis. The final multivariable model incorporated prostate-specific antigen (PSA), Grade Group, magnetic resonance imaging (MRI) score (Prostate Imaging Reporting & Data System (PI-RADS) or Likert), and prostate volume. Calibration and discrimination were good in both internal validation (C-index 0.742, 95% CI 0.694–0.793) and external validation (C-index 0.845, 95% CI 0.712–0.958). In decision curve analysis, the model offered net benefit compared to a ‘follow-all’ strategy at risk thresholds of ≥0.08 and ≥0.04 in development and external validation, respectively. In conclusion, our model demonstrated good accuracy and clinical utility in predicting the progression on AS at 4 years post-diagnosis. Men with lower risk predictions could subsequently be offered less-intense surveillance. Further external validation in larger cohorts is now required. MDPI 2022-12-27 /pmc/articles/PMC9821695/ /pubmed/36615017 http://dx.doi.org/10.3390/jcm12010216 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Light, Alexander
Lophatananon, Artitaya
Keates, Alexandra
Thankappannair, Vineetha
Barrett, Tristan
Dominguez-Escrig, Jose
Rubio-Briones, Jose
Benheddi, Toufik
Olivier, Jonathan
Villers, Arnauld
Babureddy, Kirthana
Abdelmoteleb, Haitham
Gnanapragasam, Vincent J.
Development and External Validation of the STRATified CANcer Surveillance (STRATCANS) Multivariable Model for Predicting Progression in Men with Newly Diagnosed Prostate Cancer Starting Active Surveillance
title Development and External Validation of the STRATified CANcer Surveillance (STRATCANS) Multivariable Model for Predicting Progression in Men with Newly Diagnosed Prostate Cancer Starting Active Surveillance
title_full Development and External Validation of the STRATified CANcer Surveillance (STRATCANS) Multivariable Model for Predicting Progression in Men with Newly Diagnosed Prostate Cancer Starting Active Surveillance
title_fullStr Development and External Validation of the STRATified CANcer Surveillance (STRATCANS) Multivariable Model for Predicting Progression in Men with Newly Diagnosed Prostate Cancer Starting Active Surveillance
title_full_unstemmed Development and External Validation of the STRATified CANcer Surveillance (STRATCANS) Multivariable Model for Predicting Progression in Men with Newly Diagnosed Prostate Cancer Starting Active Surveillance
title_short Development and External Validation of the STRATified CANcer Surveillance (STRATCANS) Multivariable Model for Predicting Progression in Men with Newly Diagnosed Prostate Cancer Starting Active Surveillance
title_sort development and external validation of the stratified cancer surveillance (stratcans) multivariable model for predicting progression in men with newly diagnosed prostate cancer starting active surveillance
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821695/
https://www.ncbi.nlm.nih.gov/pubmed/36615017
http://dx.doi.org/10.3390/jcm12010216
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