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By David Douglas

NEW YORK (Reuters Health) - Updating of a prognostic nomogram appears to have increased its accuracy in predicting the likelihood of prostate cancer being noninvasive and presenting little risk, Dutch researchers report in the January issue of the Journal of Urology.

"This model," lead investigator Dr. Ewout W. Steyerberg told Reuters Health, "may help to identify a subgroup of men who are most likely to have a rather indolent prostate cancer. They do not need aggressive therapy."

Dr. Steyerberg of Erasmus Medical Center, Rotterdam and colleagues note that a variety of features including prostate specific antigen levels, Gleason grade and quantity of cancer cells at biopsy have been incorporated into nomograms for use in prognosis.

To evaluate one such nomogram, the researchers employed it in assessment of data from 247 patients with clinical stage T1C or T2A cancer who were treated with radical prostatectomy. Indolent cancer was defined as pathologically organ-confined cancer of no more than 0.5 mL in volume without poorly differentiated elements.

Overall, 49% of the group had indolent cancer, much higher than the average predicted probability, which was around 20%.

The findings led the investigators to adjust the nomogram, but there was no need to incorporate additional predictors. "Recalibrating predictions was a simple and pragmatic solution to make the model applicable to the screening setting," they explain.

In their paper, the team includes a chart for scoring PSA level, ultrasound volume, Gleason score, and the amount of cancer in biopsy cores, along with a curve plotting the score against the probability of indolent cancer.

"Using this model," Dr. Steyerberg concluded, "may contribute to reducing the overtreatment of men with prostate cancer."