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THE VIENNA NOMOGRAM: VALIDATION OF A NOVEL BIOPSY STRATEGY DEFINING THE OPTIMAL NUMBER OF CORES BASED ON PATIENT AGE AND TOTAL PROSTATE VOLUME

2005; Lippincott Williams & Wilkins; Volume: 174; Issue: 4 Part 1 Linguagem: Inglês

10.1097/01.ju.0000173924.83392.cc

1527-3792

Mesut Remzi, Yan Kit Fong, Michael Dobrovits, Theodore Anagnostou, Christian Seitz, Matthias Waldert, Mike Harik, S. Marihart, Michael Marberger, Bob Djavan,

Statistical Methods in Clinical Trials

No AccessJournal of UrologyAdult Urology: Oncology: Prostate/Testis/Penis/Urethra1 Oct 2005THE VIENNA NOMOGRAM: VALIDATION OF A NOVEL BIOPSY STRATEGY DEFINING THE OPTIMAL NUMBER OF CORES BASED ON PATIENT AGE AND TOTAL PROSTATE VOLUME MESUT REMZI, YAN KIT FONG, MICHAEL DOBROVITS, THEODORE ANAGNOSTOU, CHRISTIAN SEITZ, MATTHIAS WALDERT, MIKE HARIK, SYBILLE MARIHART, MICHAEL MARBERGER, and BOB DJAVAN MESUT REMZIMESUT REMZI More articles by this author , YAN KIT FONGYAN KIT FONG More articles by this author , MICHAEL DOBROVITSMICHAEL DOBROVITS More articles by this author , THEODORE ANAGNOSTOUTHEODORE ANAGNOSTOU More articles by this author , CHRISTIAN SEITZCHRISTIAN SEITZ More articles by this author , MATTHIAS WALDERTMATTHIAS WALDERT More articles by this author , MIKE HARIKMIKE HARIK More articles by this author , SYBILLE MARIHARTSYBILLE MARIHART More articles by this author , MICHAEL MARBERGERMICHAEL MARBERGER More articles by this author , and BOB DJAVANBOB DJAVAN More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000173924.83392.ccAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We conducted a trial in patients with prostate specific antigen (PSA) levels from 2 to 10 ng/ml to validate a newly developed nomogram that defines the optimal number of biopsy cores required for prostate cancer (PCa) detection based on patient age and total prostate volume (Vienna nomogram). Materials and Methods: A total of 502 patients underwent transrectal ultrasound guided prostate biopsy using the Vienna nomogram. These results were compared with those of a previous group of 1,051 patients who had standard octant biopsies followed by systematic repeat biopsies after 6 to 8 weeks if the initial biopsy result was negative for PCa. Results: The overall PCa detection rate using the Vienna nomogram was 36.7% compared with 22% on first and 10% on repeat biopsy in the control group. The PCa detection rate using the Vienna nomogram was superior (p=0.002) to the octant biopsy technique, and comparable to a combination of first and repeat biopsy in the control group. Multivariate analysis of the Vienna nomogram showed that only PSA and the number of cores were independent predictors of PCa detection (chi-square = 49, p <0.001). Total prostate volume, transition zone volume and age were not independent predictors of PCa detection. Conclusions: The Vienna nomogram offers an easy tool to select the optimal number of prostate biopsy cores based on patient age and total prostate volume in PSA range 2 to 10 ng/ml. Cancer detection is significantly improved (66.4%) compared to the control group. The bias factor of larger prostate volume is eliminated by using the Vienna nomogram. Moreover, the Vienna nomogram is advantageous not only in terms of the improved PCa detection rate but also economically makes systematic repeat biopsies unnecessary. References 1 : Systematic 5 region prostate biopsy is superior to sextant method for diagnosing carcinoma of the prostate. J Urol1997; 157: 199. Link, Google Scholar 2 : Extended peripheral zone biopsy schemes increase cancer detection rates and minimizes variance in prostate specific antigen and age related cancer rates: results of a community multi-practice study. J Urol2003; 169: 125. 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Volume 174Issue 4 Part 1October 2005Page: 1256-1261 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsbiopsyprostatic neoplasmsorgan sizeprostate-specific antigennomogramsMetricsAuthor Information MESUT REMZI More articles by this author YAN KIT FONG More articles by this author MICHAEL DOBROVITS More articles by this author THEODORE ANAGNOSTOU More articles by this author CHRISTIAN SEITZ More articles by this author MATTHIAS WALDERT More articles by this author MIKE HARIK More articles by this author SYBILLE MARIHART More articles by this author MICHAEL MARBERGER More articles by this author BOB DJAVAN More articles by this author Expand All Advertisement PDF downloadLoading ...