Optimizing clinical risk stratification of localized prostate cancer.

IF 2.1 3区 医学 Q2 UROLOGY & NEPHROLOGY
Vincent J Gnanapragasam
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引用次数: 0

Abstract

Purpose of review: To review the current risk and prognostic stratification systems in localised prostate cancer. To explore some of the most promising adjuncts to clinical models and what the evidence has shown regarding their value.

Recent findings: There are many new biomarker-based models seeking to improve, optimise or replace clinical models. There are promising data on the value of MRI, radiomics, genomic classifiers and most recently artificial intelligence tools in refining stratification. Despite the extensive literature however, there remains uncertainty on where in pathways they can provide the most benefit and whether a biomarker is most useful for prognosis or predictive use. Comparisons studies have also often overlooked the fact that clinical models have themselves evolved and the context of the baseline used in biomarker studies that have shown superiority have to be considered.

Summary: For new biomarkers to be included in stratification models, well designed prospective clinical trials are needed. Until then, there needs to be caution in interpretation of their use for day-to-day decision making. It is critical that users balance any purported incremental value against the performance of the latest clinical classification and multivariate models especially as the latter are cost free and widely available.

优化局限性前列腺癌的临床风险分层。
综述的目的:回顾当前局限性前列腺癌的风险和预后分层系统。探索一些最有希望的辅助临床模型和证据表明,关于他们的价值。最近的发现:有许多新的基于生物标志物的模型寻求改进、优化或取代临床模型。MRI、放射组学、基因组分类器和最近的人工智能工具在细化分层方面的价值有很好的数据。然而,尽管有大量的文献,但对于它们在哪些途径中可以提供最大的益处,以及生物标志物是否对预后或预测用途最有用,仍然存在不确定性。比较研究也常常忽略了这样一个事实,即临床模型本身也在进化,必须考虑生物标志物研究中使用的基线背景。摘要:为了将新的生物标志物纳入分层模型,需要精心设计的前瞻性临床试验。在此之前,在解释它们在日常决策中的用途时需要谨慎。至关重要的是,用户平衡任何所谓的增量价值与最新的临床分类和多变量模型的性能,特别是因为后者是免费和广泛使用的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current Opinion in Urology
Current Opinion in Urology 医学-泌尿学与肾脏学
CiteScore
5.00
自引率
4.00%
发文量
140
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​​Current Opinion in Urology delivers a broad-based perspective on the most recent and most exciting developments in urology from across the world. Published bimonthly and featuring ten key topics – including focuses on prostate cancer, bladder cancer and minimally invasive urology – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.
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