DOI: 10.29188/2222-8543-2026-19-2-104-111
For citation:
Zhilov M.S., Kotov S.V., Guspanov R.I., Yusufov A.G., Cherkasov A.A., Samoуlov D.A., Litvinov S.O. A prognostic model for the diagnosis of clinically significant prostate cancer at repeated biopsy. Experimental and Clinical Urology. 2026;19(2):104-111; https://doi.org/10.29188/2222-8543-2026-19-2-104-111
Zhilov M.S., Kotov S.V., Guspanov R.I., Yusufov A.G., Cherkasov A.A., Samoуlov D.A., Litvinov S.O.
Information about authors:
- Zhilov M.S. – postgraduate student at the Department of Urology and Andrology named after Acad. N.A. Lopatkin of the Pirogov Russian National Research Medical University (Pirogov University), Moscow, Russia; RSCI Author ID: 1167726, https://orcid.org/0000-0001-6322-7868
- Kotov S.V. – Dr. Sci., Professor, Head of the Department of Urology and Andrology named after Acad.
N.A. Lopatkin of the Pirogov Russian National Research Medical University (Pirogov University), Oncologist of the 4th oncological department of the Moscow multidisciplinary clinical center «Kommunarka», Moscow, Russia; RSCI Author ID: 667344, https://orcid.org/0000-0003-3764-6131 - Guspanov R.I. – PhD, Associate Professor of the Department of Urology and Andrology named after Acad. N.A. Lopatkin of the Pirogov Russian National Research Medical University (Pirogov University), urologist of the urological department of the City Clinical Hospital No. 1 named after N.I. Pirogov, oncologist of the 4th oncological department (oncourology) Moscow Multidisciplinary Clinical Center «Kommunarka», Moscow, Russia; RSCI Author ID: 875574, https://orcid.org/0000-0003-2321-6237
- Yusufov A.G. – PhD, Associate Professor of the Department of Urology and Andrology named after Acad. N.A. Lopatkin of the Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation (Pirogov University), Head of the Urological department of the MMCC Kommunarka of the Moscow Department of Health, Moscow, Russia; RSCI Author ID: 902934, https://orcid.org/0000-0001-8202-3844
- Cherkasov A.A. – medical resident of the Department of Urology and Andrology named after Acad. N.A. Lopatkin of the Pirogov Russian National Research Medical University (Pirogov University), Moscow, Russia; Author ID: 1021198 https://orcid.org/0000-0001-8355-3644
- Samoylov D.A. – medical resident of the Department of Urology and Andrology named after Acad. N.A. Lopatkin of the Pirogov Russian National Research Medical University (Pirogov University), Moscow, Russia; RSCI Author ID: 1309392, https://orcid.org/0009-0000-4842-6551
- Litvinov S.O. – medical resident of the Department of Urology and Andrology named after Acad. N.A. Lopatkin of the Pirogov Russian National Research Medical (Pirogov University), Moscow, Russia; RSCI Author ID: 1308784, https://orcid.org/0009-0000-8006-1513
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Introduction. Currently, the FUSION technique is the standard for repeated prostate biopsy. However, the effectiveness of the targeted method for the diagnosis of clinically significant prostate cancer ranges from 23 to 40%. The use of risk calculators allows you to select patients to select patients with a high risk of diagnosis of clinically significant prostate cancer and reduce the number of repeated biopsies performed.
The purpose of the study is to develop a universal prognostic model for the diagnosis of clinically significant prostate cancer after repeated biopsy.
Materials and methods. The study included 246 patients who underwent repeated biopsy using FUSION technology. Preoperative clinical, laboratory, and instrumental data were evaluated. The result of the statistical analysis was the impact on the diagnosis of clinically significant prostate cancer (ISUP 2 or more).
Results. The analysis revealed factors that significantly affect the diagnosis of csPC during repeated biopsy: the presence of a lesion in the peripheral zone according to mpMRI (p=0.001); PIRADS v2.1 – 4 and 5 categories (p=0.001), the presence of a lesion according to finger rectal examination (PRI) (p=0.001), the size of the lesion according to mpMRI, mm: more than 13 (p=0.029), PSA density more than 0.16 ng/ml/cm3 (p=0.001), prostate volume less than 56.00 cm3 (p<0.001). A logistic regression and ROC analysis were performed for the identified parameters. The area under the AUC curve was 0,806 with a 95% confidence interval from 0,737 to 0,875. A prognostic tool for the diagnosis of clinically significant prostate cancer during repeated biopsy with an accuracy of 84% has been developed. When validating the developed calculator, the sensitivity of the model was 95.5%, the specificity was 51.28%, with a threshold value of 0.15, it is possible to refrain from 42% of repeated biopsies.
Conclusion. The prognostic model developed based on our own data shows high sensitivity and allows us to diagnose 95.5% of clinically significant prostate cancer and reduce the number of repeated prostate biopsies by 42%. This calculator can be used in the daily practice of a urologist or oncologist to assess the risk of diagnosis in a patient with cancer before performing a repeat biopsy.
