External validation of Cormio nomogram for predicting all prostate cancers and clinically significant prostate cancers

Luca Cindolo, Riccardo Bertolo, Andrea Minervini, Francesco Sessa, Gianluca Muto, Pierluigi Bove, Matteo Vittori, Giorgio Bozzini, Pietro Castellan, Filippo Mugavero, Mario Falsaperla, Luigi Schips, Antonio Celia, Maida Bada, Angelo Porreca, Antonio Pastore, Yazan Al Salhi, Marco Giampaoli, Giovanni Novella, Riccardo RizzettoNicoló Trabacchin, Guglielmo Mantica, Giovannalberto Pini, Riccardo Lombardo, Andrea Tubaro, Alessandro Antonelli, Cosimo De Nunzio

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Recently, the Cormio et al. nomogram has been developed to predict prostate cancer (PCa) and clinically significant PCa using benign prostatic obstruction parameters. The aim of the present study was to externally validate the nomogram in a multicentric cohort. Methods: Between 2013 and 2019, patients scheduled for ultrasound-guided prostate biopsy were prospectively enrolled at 11 Italian institutions. Demographic, clinical and histological data were collected and analysed. Discrimination and calibration of Cormio nomogram were assessed with the receiver operator characteristics (ROC) curve and calibration plots. The clinical net benefit of the nomogram was assessed with decision curve analysis. Clinically significant PCa was defined as ISUP grade group ' 1. Results: After accounting for inclusion criteria, 1377 patients were analysed. 816/1377 (59%) had cancer at final pathology (574/816, 70%, clinically significant PCa). Multivariable analysis showed age, prostate volume, DRE and post-voided residual volume as independent predictors of any PCa. Discrimination of the nomogram for cancer was 0.70 on ROC analysis. Calibration of the nomogram was excellent (p = 0.94) and the nomogram presented a net benefit in the 40–80% range of probabilities. Multivariable analysis for predictors of clinically significant PCa found age, PSA, prostate volume and DRE as independent variables. Discrimination of the nomogram was 0.73. Calibration was poor (p = 0.001) and the nomogram presented a net benefit in the 25–75% range of probabilities. Conclusion: We confirmed that the Cormio nomogram can be used to predict the risk of PCa in patients at increased risk. Implementation of the nomogram in clinical practice will better define its role in the patient’s counselling before prostate biopsy.

Original languageEnglish
Pages (from-to)2555-2561
Number of pages7
JournalWorld Journal of Urology
Volume38
Issue number10
DOIs
Publication statusPublished - Oct 1 2020

Keywords

  • Nomograms
  • Prostate biopsy
  • Prostatic hyperplasia
  • Prostatic neoplasms
  • Validation

ASJC Scopus subject areas

  • Urology

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