title: Predicting Low-Risk Prostate Cancer from Transperineal Saturation Biopsies.
abstract: Introduction. To assess the performance of five previously described clinicopathological definitions of low-risk prostate cancer (PC). Materials and Methods. Men who underwent radical prostatectomy (RP) for clinical stage ≤T2, PSA <10 ng/mL, Gleason score <8 PC, diagnosed by transperineal template-guided saturation biopsy were included. The performance of five previously described criteria (i.e., criteria 1-5, criterion 1 stringent (Gleason score 6 + ≤5 mm total max core length PC + ≤3 mm max per core length PC) up to criterion 5 less stringent (Gleason score 6-7 with ≤5% Gleason grade 4) was analysed to assess ability of each to predict insignificant disease in RP specimens (defined as Gleason score ≤6 and total tumour volume <2.5 mL, or Gleason score 7 with ≤5% grade 4 and total tumour volume <0.7 mL). Results. 994 men who underwent RP were included. Criterion 4 (Gleason score 6) performed best with area under the curve of receiver operating characteristics 0.792. At decision curve analysis, criterion 4 was deemed clinically the best performing transperineal saturation biopsy-based definition for low-risk PC. Conclusions. Gleason score 6 disease demonstrated a superior trade-off between sensitivity and specificity for clarifying low-risk PC that can guide treatment and be used as reference test in diagnostic studies.
authors.affiliation: St Vincent's Prostate Cancer Centre, St Vincent's Clinic, Sydney, NSW 2010, Australia; Australian Prostate Cancer Research Centre New South Wales, The Garvan Institute of Medical Research, The Kinghorn Cancer Centre, Sydney, NSW 2010, Australia.
authors.forename: Pim J
authors.initials: PJ
authors.lastname: van Leeuwen
authors.affiliation: St Vincent's Prostate Cancer Centre, St Vincent's Clinic, Sydney, NSW 2010, Australia; Australian Prostate Cancer Research Centre New South Wales, The Garvan Institute of Medical Research, The Kinghorn Cancer Centre, Sydney, NSW 2010, Australia; University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Amila
authors.initials: A
authors.lastname: Siriwardana
authors.affiliation: Department of Urology, Erasmus University Medical Center, 3015 CE Rotterdam, Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: Roobol
authors.affiliation: St Vincent's Prostate Cancer Centre, St Vincent's Clinic, Sydney, NSW 2010, Australia; Australian Prostate Cancer Research Centre New South Wales, The Garvan Institute of Medical Research, The Kinghorn Cancer Centre, Sydney, NSW 2010, Australia.
authors.forename: Francis
authors.initials: F
authors.lastname: Ting
authors.affiliation: Department of Public Health, Erasmus University Medical Center, 3015 CE Rotterdam, Netherlands.
authors.forename: Daan
authors.initials: D
authors.lastname: Nieboer
authors.affiliation: St Vincent's Prostate Cancer Centre, St Vincent's Clinic, Sydney, NSW 2010, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Thompson
authors.affiliation: University of Notre Dame, Sydney, NSW 2010, Australia.
authors.forename: Warick
authors.initials: W
authors.lastname: Delprado
authors.affiliation: Australian Prostate Cancer Research Centre New South Wales, The Garvan Institute of Medical Research, The Kinghorn Cancer Centre, Sydney, NSW 2010, Australia.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Haynes
authors.affiliation: St Vincent's Prostate Cancer Centre, St Vincent's Clinic, Sydney, NSW 2010, Australia; Australian Prostate Cancer Research Centre New South Wales, The Garvan Institute of Medical Research, The Kinghorn Cancer Centre, Sydney, NSW 2010, Australia.
authors.forename: Phillip
authors.initials: P
authors.lastname: Brenner
authors.affiliation: St Vincent's Prostate Cancer Centre, St Vincent's Clinic, Sydney, NSW 2010, Australia; Australian Prostate Cancer Research Centre New South Wales, The Garvan Institute of Medical Research, The Kinghorn Cancer Centre, Sydney, NSW 2010, Australia.
authors.forename: Phillip
authors.initials: P
authors.lastname: Stricker