Gleason sum upgrading between biopsy and radical prostatectomy in Chinese population: Updated nomograms | Actas Urológicas Españolas (English Edition)

array:24 ["pii" => "S2173578617300124" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2017.02.004" "estado" => "S300" "fechaPublicacion" => "2017-04-01" "aid" => "904" "copyright" => "AEU" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2017;41:162-71" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5 "formatos" => array:2 [ "HTML" => 4 "PDF" => 1 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0210480616301097" "issn" => "02104806" "doi" => "10.1016/j.acuro.2016.04.015" "estado" => "S300" "fechaPublicacion" => "2017-04-01" "aid" => "904" "copyright" => "AEU" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2017;41:162-71" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 49 "formatos" => array:2 [ "HTML" => 44 "PDF" => 5 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "Artículo original" "titulo" => "Infragradación de la biopsia de próstata respecto a la pieza de prostatectomía la población china: nomogramas actualizados" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "162" "paginaFinal" => "171" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Gleason sum upgrading between biopsy and radical prostatectomy in Chinese population: Updated nomograms" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2105 "Ancho" => 2546 "Tamanyo" => 385950 ] ] "descripcion" => array:1 [ "es" => "Nomograma para predecir la supragraduación patológica de la suma de Gleason en las muestras de prostatectomía radical respecto a la muestra de biopsia en la cohorte principal. A. Gráfico de calibración de las probabilidades predichas y observadas de supragraduación de suma de Gleason en la cohorte principal (n=237). La probabilidad predicha por el nomograma de supragraduación de suma de Gleason se representa en el eje X y la tasa observada de actualización se representa en el eje Y. B. Nomograma para predecir la supragraduación en las muestras de prostatectomía radical respecto a las muestra de biopsia. C. Gráfico de calibración de las probabilidades predichas y observadas de la supragraduación de la suma de Gleason significativa en pacientes con suma de Gleason <8 (n=193). La predicción calculada utilizando el nomograma se traza en el eje X, y la tasa observada de supragraduación patológica de suma de Gleason significativa se traza en el eje Y." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "H. Xu, P.D. Bai, M.B. Hu, S.H. Mao, W.H. Zhu, J.M. Hu, S.H. Liu, T. Yang, J.Y. Hou, Y. Hu, Q. Ding, H.W. Jiang" "autores" => array:12 [ 0 => array:2 [ "nombre" => "H." "apellidos" => "Xu" ] 1 => array:2 [ "nombre" => "P.D." "apellidos" => "Bai" ] 2 => array:2 [ "nombre" => "M.B." "apellidos" => "Hu" ] 3 => array:2 [ "nombre" => "S.H." "apellidos" => "Mao" ] 4 => array:2 [ "nombre" => "W.H." "apellidos" => "Zhu" ] 5 => array:2 [ "nombre" => "J.M." "apellidos" => "Hu" ] 6 => array:2 [ "nombre" => "S.H." "apellidos" => "Liu" ] 7 => array:2 [ "nombre" => "T." "apellidos" => "Yang" ] 8 => array:2 [ "nombre" => "J.Y." "apellidos" => "Hou" ] 9 => array:2 [ "nombre" => "Y." "apellidos" => "Hu" ] 10 => array:2 [ "nombre" => "Q." "apellidos" => "Ding" ] 11 => array:2 [ "nombre" => "H.W." "apellidos" => "Jiang" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173578617300124" "doi" => "10.1016/j.acuroe.2017.02.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578617300124?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480616301097?idApp=UINPBA00004N" "url" => "/02104806/0000004100000003/v1_201703250108/S0210480616301097/v1_201703250108/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173578617300227" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2017.02.014" "estado" => "S300" "fechaPublicacion" => "2017-04-01" "aid" => "920" "copyright" => "AEU" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2017;41:172-80" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3 "HTML" => 3 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Expression of proteins FGFR3, PI3K, AKT, p21Waf1/Cip1 and cyclins D1 and D3 in patients with T1 bladder tumors: Clinical implications and prognostic significance" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "172" "paginaFinal" => "180" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Expresión de las proteínas FGFR3, PI3K, AKT, p21Waf1/Cip1 y ciclinas D1 y D3 en pacientes con tumores de vejiga T1: implicaciones clínicas y significado pronóstico" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1574 "Ancho" => 2168 "Tamanyo" => 165494 ] ] "descripcion" => array:1 [ "en" => "Scheme depicting the intracellular signaling pathway involving the biomarkers FGFR3, PI3K, AKT, in addition to the cell cycle regulators p21 and cyclins D1 and D3." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A.M. Blanca Pedregosa, Á. Sánchez-González, J. Carrasco Valiente, J.M. Ruiz García, E. Gómez Gómez, A. López Beltrán, M.J. Requena Tapia" "autores" => array:7 [ 0 => array:2 [ "nombre" => "A.M." "apellidos" => "Blanca Pedregosa" ] 1 => array:2 [ "nombre" => "Á." "apellidos" => "Sánchez-González" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Carrasco Valiente" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Ruiz García" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Gómez Gómez" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "López Beltrán" ] 6 => array:2 [ "nombre" => "M.J." "apellidos" => "Requena Tapia" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480616301322" "doi" => "10.1016/j.acuro.2016.09.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480616301322?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578617300227?idApp=UINPBA00004N" "url" => "/21735786/0000004100000003/v1_201703250114/S2173578617300227/v1_201703250114/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173578617300112" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2017.02.003" "estado" => "S300" "fechaPublicacion" => "2017-04-01" "aid" => "934" "copyright" => "AEU" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2017;41:155-61" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 7 "formatos" => array:2 [ "HTML" => 5 "PDF" => 2 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Higher number of transrectal ultrasound guided prostate biopsy cores is associated with higher blood loss and perioperative complications in robot assisted radical prostatectomy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "155" "paginaFinal" => "161" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Un mayor número de cilindros de biopsia transrectal de próstata guiada por ultrasonido se asocia con una mayor pérdida de sangre y complicaciones perioperatorias en la prostatectomía radical asistida por robot" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Carneiro, A. Sivaraman, R. Sanchez-Salas, I. Nunes-Silva, M. Baghdadi, V. Srougi, E. di Trapani, F. Uriburu Pizzaro, S. Doizi, E. Barret, F. Rozet, M. Galiano, X. Cathelineau" "autores" => array:13 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Carneiro" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Sivaraman" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Sanchez-Salas" ] 3 => array:2 [ "nombre" => "I." "apellidos" => "Nunes-Silva" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Baghdadi" ] 5 => array:2 [ "nombre" => "V." "apellidos" => "Srougi" ] 6 => array:2 [ "nombre" => "E." "apellidos" => "di Trapani" ] 7 => array:2 [ "nombre" => "F. Uriburu" "apellidos" => "Pizzaro" ] 8 => array:2 [ "nombre" => "S." "apellidos" => "Doizi" ] 9 => array:2 [ "nombre" => "E." "apellidos" => "Barret" ] 10 => array:2 [ "nombre" => "F." "apellidos" => "Rozet" ] 11 => array:2 [ "nombre" => "M." "apellidos" => "Galiano" ] 12 => array:2 [ "nombre" => "X." "apellidos" => "Cathelineau" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480616301590" "doi" => "10.1016/j.acuro.2016.09.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480616301590?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578617300112?idApp=UINPBA00004N" "url" => "/21735786/0000004100000003/v1_201703250114/S2173578617300112/v1_201703250114/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Gleason sum upgrading between biopsy and radical prostatectomy in Chinese population: Updated nomograms" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "162" "paginaFinal" => "171" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "H. Xu, P.D. Bai, M.B. Hu, S.H. Mao, W.H. Zhu, J.M. Hu, S.H. Liu, T. Yang, J.Y. Hou, Y. Hu, Q. Ding, H.W. Jiang" "autores" => array:12 [ 0 => array:3 [ "nombre" => "H." "apellidos" => "Xu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "P.D." "apellidos" => "Bai" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "M.B." "apellidos" => "Hu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "S.H." "apellidos" => "Mao" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "W.H." "apellidos" => "Zhu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "J.M." "apellidos" => "Hu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "S.H." "apellidos" => "Liu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 7 => array:3 [ "nombre" => "T." "apellidos" => "Yang" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 8 => array:3 [ "nombre" => "J.Y." "apellidos" => "Hou" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 9 => array:3 [ "nombre" => "Y." "apellidos" => "Hu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 10 => array:3 [ "nombre" => "Q." "apellidos" => "Ding" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 11 => array:4 [ "nombre" => "H.W." "apellidos" => "Jiang" "email" => array:1 [ 0 => "haowen_jiang@126.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Urología, Hospital Huashan, Universidad Fudan, Shanghai, PR China" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Urología, The First Affiliated Hospital of Xiamen University, Fujian, PR China" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Infragradación de la biopsia de próstata respecto a la pieza de prostatectomía la población China: nomogramas actualizados" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2125 "Ancho" => 2547 "Tamanyo" => 360326 ] ] "descripcion" => array:1 [ "en" => "Nomogram for predicting Gleason sum upgrading between biopsy and radical prostatectomy specimens in main cohort. (A) Calibration plot of the predicted and observed probabilities of Gleason sum upgrading in the main cohort (n=237). The nomogram-predicted probability of biopsy Gleason sum upgrading is plotted on the X-axis, and the observed rate of upgrading is plotted on the Y-axis. (B) Nomogram for predicting Gleason sum upgrading between biopsy and radical prostatectomy. (C) Calibration plot of the predicted and observed probabilities of significant Gleason sum upgrading in patients with Gleason sum<8 (n=193). The prediction calculated using the nomogram is plotted on the X-axis, and the observed rate of significant Gleason sum upgrading is plotted on the Y-axis." ] ] ] "textoCompleto" => "IntroductionProstate adenocarcinoma is the most common prostate cancer. In clinical practice, prostate adenocarcinoma is graded by the Gleason system, which was developed in 1966 by Dr Donald Gleasonm,<a class="elsevierStyleCrossRef" href="#bib0150">1</a> a pathologist from Minneapolis, USA. Using low-power microscopy, prostate adenocarcinoma is graded from 1 to 5 according to its gland-forming differentiation. Both specimens from prostate biopsy and radical prostatectomy (RP) will be graded with a certain Gleason score (GS).However, previous researches indicated that there existed the possibility of mismatch of GS after RP compared with biopsy.<a class="elsevierStyleCrossRefs" href="#bib0155">2,3</a> Approximately one third of patients would have a diagnosis of more aggressive prostate adenocarcinoma with a higher GS at RP than was diagnosed at biopsy.<a class="elsevierStyleCrossRefs" href="#bib0165">4–6</a> In clinical practice, GS is one of the most important parameters for consideration when urologists offer the suitable treatment choices to the patient. The change of GS after RP, especially upgrading of GS, might alter the treatment option, since some surgical interventions would have been avoided if patients were diagnosed with high-risk prostate adenocarcinoma at biopsy.In order to avoid overtreatment caused by Gleason sum (sumGS) upgrading between RP and biopsy, several models have been developed to predict the probability of sumGS upgrading in European or American patients in the last decade.<a class="elsevierStyleCrossRefs" href="#bib0170">5,6</a> These models were designed to reduce unnecessary surgeries and make more economic-effective treatment decisions. PSA screening is widely practiced in western countries, and the mean PSA value of these studies was mostly less than 10ng/mL. However, PSA screening is not as widely carried out in China as in western countries, which leads to the fact that quite a few patients have a relatively higher PSA value at diagnosis.Last year, Wang et al. carried out the first study aiming to build a nomogram for the prediction of SumGS upgrading in prostate adenocarcinoma in the Chinese population.<a class="elsevierStyleCrossRef" href="#bib0165">4</a> Patients included in that study were admitted due to clinical symptoms such as urinary frequency, urgency, dysuria, and hematuria from 2006 to 2011. However, since PSA screening is becoming popular and widely accepted in China, more and more patients referred to the hospital for further examination due to elevated PSA value. We would like to build a new nomogram based on the database of the last five years in our center.MethodsPatient populationBetween February 2011 and May 2015, 260 consecutive patients received RP at the Huashan Hospital, Fudan University. All patients were ethnic Han Chinese, who were informed about the aims and requirements of this study. Informed consent for participation was obtained in accordance with institutional guidance at Huashan Hospital. Clinical and pathological data were retrospectively gathered. All these patients had biopsy-proven prostate adenocarcinoma. Of these, 188 patients received biopsy at our hospital. Their specimens were directly sent to the Pathology Department of our hospital. The rest of the patients received biopsy in other hospitals, and their biopsy sections were re-examined by pathologists from our hospital. Prostate adenocarcinoma grading was made according to the 2005 International Society of Urological Pathology (ISUP) consensus conference on Gleason grading of prostatic carcinoma.<a class="elsevierStyleCrossRef" href="#bib0180">7</a>Overall, 23 patients were excluded. 16 patients were excluded because of missing data (clinical stage, PSA, primary or secondary biopsy GS, primary or secondary pathologic GS), and 7 patients were excluded because no prostate adenocarcinoma was detected after RP. A total of 237 evaluable patients were included in the analysis. Of these, 6 patients (2.53%) had clinical stage T3 prostate cancer.Clinical and pathologic evaluationPatients’ height and weight were recorded when they were admitted to our hospital for RP. Body-mass index (BMI) was calculated accordingly. Clinical stage was assigned by the attending urologist according to the 2009 TNM system.<a class="elsevierStyleCrossRef" href="#bib0185">8</a> All these patients had pre-operative computed tomography (CT) or magnetic resonance imaging (MRI) for local and lymph nodes staging, and bone scan or positron emission computed tomography (PET-CT) for distal staging. 10-core biopsy was applied under transrectal ultrasound (TRUS) guidance. Pre-operative PSA was measured before digital rectal examination (DRE) and TRUS. Some patients already had PSA results in outpatient clinic. All prostatectomy specimens were also graded according to the Gleason system. No patient received neoadjuvant androgen therapy.Statistical analysesThe main outcome of our study was sumGS upgrading between biopsy and RP pathology. In order to explore potential predictors of sumGS upgrading, we applied age, BMI, PSA, DRE results, clinical T stage, primary and secondary biopsy Gleason scores, as well as sumGS in univariate and multivariate logistic regression models. The prediction model was further evaluated for its ability to predict significant upgrading in patients with biopsy sumGS<8. The statistical performance of the prediction model was assessed by both discrimination and calibration ability. Discrimination ability was measured using the concordance index (C-index). Bootstrap-corrected C-indexes were further calculated to better estimate expected future predictive accuracy. Calibration ability was assessed by both calibration plot of predicted probability of sumGS upgrading versus actual outcomes and by the Spiegelhalter Z-test. All statistical tests were performed using SPSS version 19.0 and software R 2.11.1. Moreover, all tests were two-sided with a significance level at 0.05.ResultsBasic and clinical dataPatient characteristics are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Among all the 237 patients included, the mean age was 67.8 (median: 67, range: 47–86), the mean BMI was 23.76kg/m2 (median: 23.66kg/m2, range: 16.07–31.80kg/m2), and the mean pre-operative PSA level was 19.23ng/mL (median: 13.43ng/mL, range: 1.00–293.30ng/mL). Of these, 176 patients had prostate volume data measured by TRUS with a mean volume of 38.18mL (median: 36mL, range: 12–98mL), and 67 patients (28.27%) had abnormal digital rectal examination. PSA values over 20ng/mL were recorded in 69 patients (29.11%) and 76 (32.07%) had PSA values below 20ng/mL. Clinical stage T1 accounted for 123 patients (51.90%), and T2 accounted for 108 patients (45.57%).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Among the 237 patients, 115 (48.52%) had standardized biopsy data including number of positive cores and positive side data. Of these patients, the mean age was 68.1 years old (median: 67, range: 55–83), the mean BMI was 24.17kg/m2 (median: 23.83kg/m2, range: 17.23–31.80kg/m2), and the mean pre-operative PSA level was 16.98ng/mL (median: 12.44ng/mL, range: 3.47–52.53ng/mL). Among this sub-cohort, 89 patients had prostate volume data measured by TRUS with a mean volume of 37.94mL (median: 37mL, range: 13–75mL), and abnormal digital rectal examination was observed in 46 patients (28.27%). PSA values over 20ng/mL were recorded in 34 patients (29.57%) and 33 (28.70%) had PSA values below 20ng/mL. Clinical stage T1 accounted for 65 patients (56.52%), and T2 accounted for 46 patients (40.00%).Pathological data<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> showed pathological data of biopsy and RP in both the main cohort and the sub-cohort. We also listed the details of Gleason score of both biopsy and RP (see Appendix A). In the main cohort, upgrading was recorded in 62 (26.16%), whereas 10.97% were downgraded. The same sumGS at biopsy and pathology was found in 149 (62.87%). And in the sub-cohort, upgrading was recorded in 31 (26.96%), whereas 12.17% were downgraded. The same sumGS at biopsy and pathology was found in 70 (60.87%).Nomogram developmentIn the main cohort, pre-operative PSA level, DRE abnormality, clinical T stage, secondary GS and sumGS were significant predictors of sumGS upgrading between biopsy and final pathology in univariate analysis. These variables were then included in multivariate analysis. As shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>, DRE abnormality [OR: 2.133, 95% confidence interval (CI): 0.912–4.987, P: 0.08] was moderately significant and was added to the model for assessment, together with two significant predictors, namely pre-operative PSA level (OR: 1.06, 95% CI: 1.033–1.088, P<0.001) and biopsy sumGS (OR: 0.421, 95% CI: 0.220–0.804, P: 0.009). The C-index was 0.798, and the bootstrap-corrected C-index was 0.787. The calibration plot demonstrated that the rate of predicted sumGS upgrading paralleled the observed rate well (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). Based on these results from the main cohort, a nomogram was constructed to predict sumGS upgrading in a user-friendly manner (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). To investigate the nomogram's ability to predict significant upgrading, we used it to evaluate 193 patients with biopsy sumGS<8. In this validation group, 56 (29.02%) patients had sumGS upgrading. The prediction model showed a good discrimination ability (C-index: 0.788), and the Spiegelhalter Z-test indicated good calibration (P: 0.909) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia>Since the number of positive cores and whether these cores were bilateral or unilateral were also important to predict sumGS upgrading, we tried to draw the preliminary nomogram based on the sub-cohort. In the sub-cohort, pre-operative PSA level, secondary GS, sumGS, number of positive cores, and positive side were significant predictors of sumGS upgrading between biopsy and final pathology in univariate analysis. These variables were then included in multivariate analysis. Number of positive cores (OR: 1.025, 95% CI: 0.996–1.054, P: 0.088) was moderately significant and was added to the model for assessment, together with two significant predictors, namely pre-operative PSA level (OR: 1.072, 95% CI: 1.015–1.132, P: 0.012) and biopsy sumGS (OR: 0.181, 95% CI: 0.059–0.577, P: 0.003). The C-index was 0.883 and the bootstrap-corrected C-index was 0.833. The calibration plot demonstrated that the rate of predicted sumGS upgrading paralleled the observed rate well (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A). Based on these results, another nomogram was also constructed (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B). To investigate the nomogram's ability to predict significant upgrading, we used it to evaluate 95 patients with biopsy SumGS<8. In this validation group, 30 (31.58%) patients had sumGS upgrading. The prediction model showed a good discrimination ability (C-index: 0.825), and the Spiegelhalter Z-test indicated good calibration (P: 0.918) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>C).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>DiscussionBased on our main cohort, we successfully developed and validated a model to predict sumGS upgrading from biopsy to final pathology using three clinical variables (pre-operative PSA level, DRE abnormality, and biopsy sumGS). Our model is 78.7% accurate, and its prediction approximated the observed rate quite well. Meanwhile, this prediction model showed good discrimination ability for significant upgrading, with a C-index of 0.788. Since the number or percentage of positive cores were also related to sumGS upgrading,<a class="elsevierStyleCrossRef" href="#bib0190">9</a> we included both number of positive cores and positive side in our sub-analysis. The preliminary nomogram included three clinical variables (pre-operative PSA level, number of positive cores, and biopsy sumGS). This preliminary model is 83.3% accurate, with good prediction capacity. It also presents good discrimination ability for significant upgrading, with a C-index of 0.825.In clinical practice, GS is one of the most important measures in choosing the suitable treatment options and closely related to patients’ prognosis. It is important to have a better understanding of the possibility of sumGS upgrading after RP as well as the potential risk factors of sumGS upgrading. In the last decade, several western studies<a class="elsevierStyleCrossRefs" href="#bib0175">6,10–13</a> took the lead in designing a visible and user-friendly manner to help us predict the possibility of sumGS upgrading. Serum PSA level, biopsy sumGS, number or percentage of positive cores, maximum percentage of cancer per core, prostate weight, and age were potential significant predictors of sumGS upgrading after RP. Much fewer studies had been carried out in Asian population. The first external validation of western-edition nomogram in Asian population was performed in 2010 in Japan, which was performed by Imamoto et al.<a class="elsevierStyleCrossRef" href="#bib0215">14</a> by using the published model designed by Chun et al.<a class="elsevierStyleCrossRef" href="#bib0175">6</a> The following year, in 2011, Imamoto et al.<a class="elsevierStyleCrossRef" href="#bib0220">15</a> produced a Japanese own nomogram for predicting sumGS upgrading between biopsy and RP. The first external validation of western-edition nomogram in China was carried out in 2014 by Wang et al.,<a class="elsevierStyleCrossRef" href="#bib0165">4</a> and he also produced a new nomogram to predict sumGS upgrading in patients with clinically diagnosed prostate cancer. Patients included in the study by Wang et al. were admitted due to clinical symptoms from 2006 to 2011. However, since PSA screening is becoming more and more widely performed in China, more and more patients referred to the hospital for further examination due to elevated PSA value. Due to this transition and change, our updated study would provide new insight into the sumGS upgrading between biopsy and RP in Chinese population.The prevalence of sumGS upgrading in our main cohort was 26.16%, which is within the range of previously reported values. Interestingly, one latest study carried out by Lendínez-Cano et al.<a class="elsevierStyleCrossRef" href="#bib0225">16</a> found that, even though 18.4% low-risk prostate adenocarcinoma patients had sumGS upgrading, only 3.8% very low risk patients (cT1c-T2a, PSA≤10ng/mL, GS≤6, affected cores<3 and PSA density≤0.15) had sumGS upgrading, indicating that very low risk prostate adenocarcinoma patients had less bad histological prognosis.In consistency with other studies, pre-operative PSA level and biopsy sumGS were significant predictors of sumGS upgrading between biopsy and RP in our main cohort. The mean PSA value was 19.23ng/mL, which was comparable with that in the study by Wang et al. (19.7ng/mL),<a class="elsevierStyleCrossRef" href="#bib0165">4</a> but it was much higher than that in the study by Imamoto et al. (13.977ng/mL)<a class="elsevierStyleCrossRef" href="#bib0220">15</a> and in the study by Chun et al. (9.6ng/mL).<a class="elsevierStyleCrossRef" href="#bib0175">6</a> Serum PSA level is crucially associated with local stage<a class="elsevierStyleCrossRef" href="#bib0230">17</a> and prognosis<a class="elsevierStyleCrossRef" href="#bib0235">18</a> of prostate adenocarcinoma. Together with its close relationship with sumGS upgrading, there was no doubt of PSA's great importance in prostate adenocarcinoma evaluation and assessment. We failed to observe a significant decrease in PSA level compared to the study by Wang et al., which indicates that a majority of patients already had high-risk prostate adenocarcinoma at diagnosis in China, although PSA screening seemed to be more widely performed.Besides PSA level, DRE is suggested to be performed routinely in urology clinic, which helps detect early prostate cancer.<a class="elsevierStyleCrossRef" href="#bib0240">19</a> In our univariate analysis, DRE (P: 0.006) was significantly associated with sumGS upgrading, which failed to remain a significant predictor in further multivariate analysis (P: 0.080). We included DRE in nomogram development due to its promising result and vital clinical meaning. However, when reviewing related studies published before, we hardly found DRE abnormality in the final nomogram. One of the possible explanations might be that the patients in our study had larger tumor nodules than those in other studies due to relatively delayed diagnosis, which was consistent with significantly higher PSA level in our study.In our study, 122 patients had missing data about standardized biopsy details of each core. So we carried out a sub-analysis of the remaining 115 patients and found that the number of positive cores was significantly associated with sumGS upgrading in univariate analysis (P: 0.041), but it was moderately significant in multivariate analysis (P: 0.088). Whether the lesion was bilateral or unilateral in the biopsy seemed not to be associated to sumGS upgrading in multivariate analysis (P: 0.267). Both number of positive cores and positive side were related to local stage at biopsy. Both Japanese-edition<a class="elsevierStyleCrossRef" href="#bib0220">15</a> and western-edition nomogram<a class="elsevierStyleCrossRef" href="#bib0175">6</a> included T stage as a significant predictor. Although our study revealed a significant association between T stage and sumGS upgrading (P: 0.038), it failed to remain significant in multivariate analysis (P: 0.336).Prostate adenocarcinoma grading, especially biopsy GS, was used in risk stratification, and influenced further treatment options. Prostate adenocarcinoma is the most common cancer in the United States and it alone is predicted to account for 1 in 5 new diagnoses in 2016.<a class="elsevierStyleCrossRef" href="#bib0245">20</a> In order to avoid overtreatment of prostate adenocarcinoma, several models have been developed to predict the probability of sumGS upgrading in western patients. However, the incidence of prostate adenocarcinoma is much lower in China.<a class="elsevierStyleCrossRef" href="#bib0250">21</a> Different genetic background as well as lifestyle and environment exposure might explain the difference, but less popular PSA screening and public awareness of prostate adenocarcinoma might also contribute to the giant gap. As a result, the treatment strategy of prostate adenocarcinoma in China might be somehow more active and aggressive compared toWestern countries. Those patients with a GS≤6, as well as stage T1c or T2a, PSA≤10ng/mL, and age≤70, or a GS≤7 and age>70, were candidates for active surveillance.<a class="elsevierStyleCrossRefs" href="#bib0255">22,23</a> However, taking into account that quite a few patients would encounter Gleason upgrading after RP (our study showed that more than one fourth of patients were diagnosed with upgrading GS after RP), risk existed that a higher Gleason grade prostate adenocarcinoma was missed in biopsy. In such cases, active surveillance might postpone the curative treatment. RP or radiotherapy might be more appropriate for those low-risk patients but who have great potential Gleason upgrading.The main cause of the relative low matching ratio between biopsy and RP GS was that most prostate adenocarcinoma cases are multifocal.<a class="elsevierStyleCrossRef" href="#bib0265">24</a> Although it was guided by TRUS, the detection rate was often lower than 50%<a class="elsevierStyleCrossRef" href="#bib0270">25</a> and many aggressive cancers were missed. In order to improve the detection rate, new sonographic modalities such as sonoelastography and contrast-enhanced ultrasound have being investigated. But no clear advantage of these targeted biopsies over the current standard of systematic 10–12 core biopsy schemes was observed.<a class="elsevierStyleCrossRef" href="#bib0275">26</a> Besides, the use of multiparametric magnetic resonance imaging (mpMRI) and ultrasound image fusion-guided targeted biopsy has increased. Both MRI/TRUS image fusion guided transrectal<a class="elsevierStyleCrossRef" href="#bib0280">27</a> and transperineal<a class="elsevierStyleCrossRef" href="#bib0285">28</a> prostate biopsy detect more clinically significant GS 7–10 cancers and fewer insignificant GS 6 cancers than TRUS guided biopsy. The wide use of MRI/TRUS image fusion guided prostate biopsy might increase the matching ratio between biopsy and RP GS.Our study was designed to assess the risk factors of sumGS upgrading between biopsy and RP in the last five years when PSA screening was becoming relatively more widely performed in China. Our nomograms had acceptable accuracy and worked well. But several limitations have to be considered. First, both DRE abnormality and number of positive cores, despite being included in nomogram development, were not significant predictors, owing to limited sample size. We are going to continue the study prospectively and further assess these variables on a larger scale based on their potential shown in our present study. Second, although all the patients included underwent 10-core biopsy, they had inconsistent biopsy details since some of them received biopsy at other hospitals. In the future, we are going to apply the standardized biopsy report format in our hospital, which would provide more comparable indicators. Third, there have been many changes about Gleason's recommendations between the 2005 grading conference and the 2014 conference. According to both the 2014 International Society of Urological Pathology (ISUP) consensus conference on Gleason grading of prostatic carcinoma<a class="elsevierStyleCrossRef" href="#bib0290">29</a> and 2016 European Association of Urology Guidelines on Prostate Cancer, sumGS≤6 was classified as Gleason group 1. The new Gleason classification might provide more accurate stratification of tumors than the current system. In a future study, we would apply the new Gleason classification system and try to validate its use in Chinese population.ConclusionPre-operative PSA level and biopsy Gleason sum were significant predictors of Gleason sum upgrading between biopsy and RP. DRE result and number of positive cores were also respectively included in the two models for their moderate significance and important clinical meaning. User-friendly nomograms to predict Gleason sum upgrading in Chinese population were developed, demonstrating good statistical performance upon internal validation.FundingThis study was sponsored by the National Natural Science Foundation of China (No. 81272835), the Program for New Century Excellent Talents in University, China (NCET-13-0136), the Shanghai Education Committee Scientific Research Innovation Project, China (No. 14ZZ010), and the Shanghai Talent Development Foundation (No. 201302).Conflict of interestThe authors declare that they have no conflict of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres820141" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec817073" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres820140" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec817072" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Patient population" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Clinical and pathologic evaluation" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analyses" ] ] ] 6 => array:3 [ "identificador" => "sec0030" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Basic and clinical data" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Pathological data" ] 2 => array:2 [ "identificador" => "sec0045" "titulo" => "Nomogram development" ] ] ] 7 => array:2 [ "identificador" => "sec0050" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0055" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0060" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0065" "titulo" => "Conflict of interest" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-02-22" "fechaAceptado" => "2016-04-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec817073" "palabras" => array:5 [ 0 => "Biopsy" 1 => "Gleason score" 2 => "Nomogram" 3 => "Prostate adenocarcinoma" 4 => "Radical prostatectomy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec817072" "palabras" => array:5 [ 0 => "Biopsia" 1 => "Puntuación de Gleason" 2 => "Nomograma" 3 => "Adenocarcinoma de próstata" 4 => "Prostatectomía radical" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionTo assess the risk factors of Gleason sum upgrading between biopsy and radical prostatectomy (RP) and update the nomogram for the prediction of Gleason sum upgrading. MethodsThe study cohort consisted of 237 Chinese prostate adenocarcinoma patients who underwent 10-core prostate biopsy and subsequently received RP in Huashan Hospital from February 2011 to May 2015. The main outcome of our study was Gleason sum upgrading between biopsy and RP pathology. Univariate and multivariate logistic regression models were conducted to explore the potential predictors, and ultimately to build the nomograms. The prediction model was further evaluated for its ability to predict significant upgrading in patients with biopsy Gleason sum<8. ResultsIn the main cohort of all the patients, Gleason sum upgrading was observed in 62 (26.16%) patients. The pre-operative prostate-specific antigen (PSA) level, biopsy Gleason sum, and digital rectal examination were used in building the nomogram, which was validated internally with a bootstrap-corrected concordance index of 0.787. In the sub-cohort of 115 patients with standardized biopsy details, Gleason sum upgrading was observed in 31 (26.96%) patients. The pre-operative PSA level, biopsy Gleason sum, and number of positive cores were used in the nomogram, which was also validated internally with a bootstrap-corrected concordance index of 0.833. These two nomograms both demonstrated satisfactory statistical performance for predicting significant upgrading. ConclusionsUpdated nomograms to predict Gleason sum upgrading in Chinese population between biopsy and RP were developed, demonstrating good statistical performance upon internal validation." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónEvaluar los factores de riesgo de la supragraduación de la suma de Gleason en la prostatectomía radical (PR) y actualizar el nomograma para la predicción de la infragraduación de la biopsia respecto a la pieza de prostatectomía radical. MétodosLa cohorte del estudio consistió en 237 pacientes chinos con adenocarcinoma de próstata que fueron sometidos a biopsia de próstata de 10 cilindros y posteriormente fueron sometidos PR en el Hospital Huashan, entre febrero de 2011 y mayo de 2015. El principal objetivo de nuestro estudio fue el estudio de la supragraduación de la suma de Gleason respecto a la biopsia en la muestra de PR. Se realizaron modelos de regresión logística univariante y multivariante para explorar los potenciales factores predictivos, y en última instancia para construir los nomogramas. El modelo de predicción se evaluó por su capacidad para predecir la supragraduación significativa en pacientes con suma de Gleason de biopsia <8. ResultadosEn la cohorte principal se observó supragraduación de la suma de Gleason en 62 (26,16%) pacientes. El nivel de antígeno específico de próstata (PSA) preoperatorio, la suma de Gleason de biopsia y el tacto rectal se utilizaron en la construcción del nomograma, que fue validado internamente con un índice de concordancia corregido por bootstrap de 0,787. En la subcohorte de 115 pacientes con datos estandarizados de biopsia se observó supragraduación en 31 (26,96%) pacientes. El nivel preoperatorio de PSA, suma de Gleason de biopsia y el número de cilindros positivos se utilizaron en el nomograma, que también fue validado internamente con un índice de concordancia de corregido por bootstrap de 0,833. Estos 2 nomogramas demostraron un rendimiento estadístico satisfactorio para predecir supragraduación significativa. ConclusionesSe desarrollaron nomogramas actualizados para predecir la supragraduación de la suma de Gleason de la biopsia respecto a la PR, que demostraron un buen rendimiento estadístico tras la validación interna." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Xu H, Bai PD, Hu MB, Mao SH, Zhu WH, Hu JM, et al. Infragradación de la biopsia de próstata respecto a la pieza de prostatectomía la población China: nomogramas actualizados. Actas Urol Esp. 2017;41:162–171." ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "The following is the supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0075" ] ] ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2125 "Ancho" => 2547 "Tamanyo" => 360326 ] ] "descripcion" => array:1 [ "en" => "Nomogram for predicting Gleason sum upgrading between biopsy and radical prostatectomy specimens in main cohort. (A) Calibration plot of the predicted and observed probabilities of Gleason sum upgrading in the main cohort (n=237). The nomogram-predicted probability of biopsy Gleason sum upgrading is plotted on the X-axis, and the observed rate of upgrading is plotted on the Y-axis. (B) Nomogram for predicting Gleason sum upgrading between biopsy and radical prostatectomy. (C) Calibration plot of the predicted and observed probabilities of significant Gleason sum upgrading in patients with Gleason sum<8 (n=193). The prediction calculated using the nomogram is plotted on the X-axis, and the observed rate of significant Gleason sum upgrading is plotted on the Y-axis." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2071 "Ancho" => 2543 "Tamanyo" => 361465 ] ] "descripcion" => array:1 [ "en" => "Nomogram for predicting Gleason sum upgrading between biopsy and radical prostatectomy specimens in sub-cohort. (A) Calibration plot of the predicted and observed probabilities of Gleason sum upgrading in the sub-cohort (n=115). The nomogram-predicted probability of biopsy Gleason sum upgrading is plotted on the X-axis, and the observed rate of upgrading is plotted on the Y-axis. (B) Nomogram for predicting Gleason sum upgrading between biopsy and radical prostatectomy. (C) Calibration plot of the predicted and observed probabilities of significant Gleason sum upgrading in patients with Gleason sum<8 (n=95). The prediction calculated using the nomogram is plotted on the X-axis, and the observed rate of significant Gleason sum upgrading is plotted on the Y-axis." ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:2 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age (y) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Main cohort: all patients (237) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sub-cohort: patients with detailed biopsy data (115) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">67.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">68.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Median \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">67 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Range \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">47–86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">55–83 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">BMI (kg/m2)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23.76 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24.17 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Median \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23.66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23.83 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Range \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16.07–31.80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17.23–31.80 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">Prostate volume (TRUS) (mL)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">38.18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37.94 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Median \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Range \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12–98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13–75 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Missing data (N) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">61 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">26 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">Pre-operative PSA (ng/mL)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19.23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16.98 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Median \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13.43 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12.44 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Range \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.00–293.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.47–52.53 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1378537.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n % \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DRE abnormality \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26.96 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">PSA (ng/mL)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.70 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">10–20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">92 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38.82 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41.74 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">>20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29.57 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">237 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">115 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Clinical stage</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">123 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">51.90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56.52 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">108 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45.57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.53 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.48 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">237 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">115 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Primary biopsy Gleason</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.84 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.87 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">157 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66.24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58.26 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36.52 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">237 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">115 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Secondary biopsy Gleason</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">122 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">51.48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58.26 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">95 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40.08 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">37.39 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">237 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">115 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Biopsy Gleason sum</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.53 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.87 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.76 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31.30 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">107 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50.43 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.08 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.30 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.09 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">237 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">115 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Primary pathological Gleason</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">157 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66.24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">72 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62.61 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.70 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.70 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">237 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">115 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Secondary pathological Gleason</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">107 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46.09 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">102 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43.04 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42.61 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.30 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">237 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">115 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Pathological Gleason sum</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.84 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26.09 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">116 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48.95 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48.70 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.65 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.96 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.61 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">237 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">115 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gleason sum upgrading \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26.16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26.96 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1378539.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Basic clinical and pathological characteristics of patients." ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:2 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " colspan="9" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Main cohort (237)</th></tr><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Univariate model</th><th class="td" title="table-head " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Multivariate model</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">B \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">P \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">B \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">P \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pre-operative PSA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.034 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.035 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.014–1.056 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.058 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.033–1.088 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.019 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.981 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.940–1.023 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.373 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.022 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.978 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.884–1.082 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.665 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DRE abnormality \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.859 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.278–4.361 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.757 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.133 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.912–4.987 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.08 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T stage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.551 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.736 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.030–2.923 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.038 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.357 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.428 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.691–2.954 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.336 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Primary biopsy Gleason \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.457 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.633 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.363–1.105 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.108 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Secondary biopsy Gleason \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.903 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.405 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.241–0.681 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.375 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.687 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.293–1.613 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.389 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Biopsy Gleason sum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.759 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.468 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.314–0.698 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.865 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.421 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.220–0.804 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.009 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sub-cohort (115) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1378538.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " colspan="9" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Sub-cohort (115)</th></tr><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Univariate model</th><th class="td" title="table-head " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Multivariate model</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">B \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">B \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">B \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pre-operative PSA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.051 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.0110–1.093 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.013 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.072 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.015–1.132 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.012 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DRE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.142 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.153 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.462–2.880 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.761 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T stage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.197 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.218 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.593–2.500 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.591 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Primary biopsy Gleason \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.654 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.52 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.240–1.126 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.097 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Secondary biopsy Gleason \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−1.164 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.312 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.128–0.764 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.011 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.169 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.845 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.222–3.219 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.805 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Biopsy Gleason sum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.955 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.385 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.202–0.732 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.004 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−1.708 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.181 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.059–0.577 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.003 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Percentage of positive cores \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.017 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.017 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.001–1.034 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.041 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.024 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.025 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.996–1.054 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.088 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Positive side \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.078 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.94 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.233–7.011 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.015 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.773 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.166 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.553–8.482 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.267 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1378540.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Univariate and multivariate logistic regression models predicting Gleason sum upgrading between biopsy and final pathology." ] ] 4 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.pdf" "ficheroTamanyo" => 7476 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib0150" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Classification of prostatic carcinomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D.F. Gleason" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Cancer Chemotherapy Rep Part 1" "fecha" => "1966" "volumen" => "50" "paginaInicial" => "125" "paginaFinal" => "128" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0155" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The accuracy of diagnostic biopsy specimens in predicting tumor grades by Gleason's classification of radical prostatectomy specimens" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.E. Garnett" 1 => "R. Oyasu" 2 => "J.T. Grayhack" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "1984" "volumen" => "131" "paginaInicial" => "690" "paginaFinal" => "693" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6708183" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0160" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gleason grading of prostatic needle biopsies. Correlation with grade in 316 matched prostatectomies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D.G. Bostwick" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "1994" "volumen" => "18" "paginaInicial" => "796" "paginaFinal" => "803" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8037294" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0165" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A nomogram to predict Gleason sum upgrading of clinically diagnosed localized prostate cancer among Chinese patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.Y. Wang" 1 => "Y. Zhu" 2 => "C.F. Wang" 3 => "S.L. Zhang" 4 => "B. Dai" 5 => "D.W. Ye" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Chinese J Cancer" "fecha" => "2014" "volumen" => "33" "paginaInicial" => "241" "paginaFinal" => "248" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0170" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and pathologic predictors of Gleason sum upgrading in patients after radical prostatectomy: results from a single institution series" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Tilki" 1 => "B. Schlenker" 2 => "M. John" 3 => "A. Buchner" 4 => "P. Stanislaus" 5 => "C. Gratzke" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.urolonc.2009.07.003" "Revista" => array:6 [ "tituloSerie" => "Urol Oncol" "fecha" => "2011" "volumen" => "29" "paginaInicial" => "508" "paginaFinal" => "514" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19837614" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0175" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Development and internal validation of a nomogram predicting the probability of prostate cancer Gleason sum upgrading between biopsy and radical prostatectomy pathology" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F.K. Chun" 1 => "T. Steuber" 2 => "A. Erbersdobler" 3 => "E. Currlin" 4 => "J. Walz" 5 => "T. Schlomm" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eururo.2005.11.007" "Revista" => array:6 [ "tituloSerie" => "Eur Urol" "fecha" => "2006" "volumen" => "49" "paginaInicial" => "820" "paginaFinal" => "826" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16439050" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0180" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The 2005 International Society of Urological Pathology (ISUP) consensus conference on Gleason grading of prostatic carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.I. Epstein" 1 => "W.C. Allsbrook Jr." 2 => "M.B. Amin" 3 => "L.L. Egevad" 4 => "I.G. Committee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "2005" "volumen" => "29" "paginaInicial" => "1228" "paginaFinal" => "1242" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16096414" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0185" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.B. Edge" 1 => "C.C. Compton" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1245/s10434-010-0985-4" "Revista" => array:6 [ "tituloSerie" => "Ann Surg Oncol" "fecha" => "2010" "volumen" => "17" "paginaInicial" => "1471" "paginaFinal" => "1474" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20180029" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0190" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Upgrading and downgrading of prostate cancer from biopsy to radical prostatectomy: incidence and predictive factors using the modified Gleason grading system and factoring in tertiary grades" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.I. Epstein" 1 => "Z. Feng" 2 => "B.J. Trock" 3 => "P.M. Pierorazio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eururo.2012.01.050" "Revista" => array:6 [ "tituloSerie" => "Eur Urol" "fecha" => "2012" "volumen" => "61" "paginaInicial" => "1019" "paginaFinal" => "1024" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22336380" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0195" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Upgrading and downgrading of prostate needle biopsy specimens: risk factors and clinical implications" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.J. Freedland" 1 => "C.J. Kane" 2 => "C.L. Amling" 3 => "W.J. Aronson" 4 => "M.K. Terris" 5 => "J.C. Presti Jr." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.urology.2006.10.036" "Revista" => array:6 [ "tituloSerie" => "Urology" "fecha" => "2007" "volumen" => "69" "paginaInicial" => "495" "paginaFinal" => "499" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17382152" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0200" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Biopsy core number represents one of foremost predictors of clinically significant gleason sum upgrading in patients with low-risk prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "U. Capitanio" 1 => "P.I. Karakiewicz" 2 => "L. Valiquette" 3 => "P. Perrotte" 4 => "C. Jeldres" 5 => "A. Briganti" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.urology.2008.10.048" "Revista" => array:6 [ "tituloSerie" => "Urology" "fecha" => "2009" "volumen" => "73" "paginaInicial" => "1087" "paginaFinal" => "1091" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19195695" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0205" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Factors predicting prostatic biopsy Gleason sum under grading" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.A. Stackhouse" 1 => "L. Sun" 2 => "F.R. Schroeck" 3 => "J. Jayachandran" 4 => "A.A. Caire" 5 => "C.O. Acholo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.juro.2009.02.127" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2009" "volumen" => "182" "paginaInicial" => "118" "paginaFinal" => "122" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19447436" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0210" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prostate cancer: new nomogram predicts risk of Gleason upgrading" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Payton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Nature Rev Urol" "fecha" => "2013" "volumen" => "10" "paginaInicial" => "553" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0215" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "External validation of a nomogram predicting the probability of prostate cancer Gleason sum upgrading between biopsy and radical prostatectomy pathology among Japanese patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Imamoto" 1 => "H. Suzuki" 2 => "T. Utsumi" 3 => "M. Takano" 4 => "T. Suyama" 5 => "K. Kawamura" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.urology.2009.05.084" "Revista" => array:6 [ "tituloSerie" => "Urology" "fecha" => "2010" "volumen" => "76" "paginaInicial" => "404" "paginaFinal" => "410" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19716590" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0220" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Development and external validation of a nomogram predicting the probability of significant gleason sum upgrading among Japanese patients with localized prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Imamoto" 1 => "T. Utsumi" 2 => "M. Takano" 3 => "A. Komaru" 4 => "S. Fukasawa" 5 => "T. Suyama" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2011/754382" "Revista" => array:5 [ "tituloSerie" => "Prostate Cancer" "fecha" => "2011" "volumen" => "2011" "paginaInicial" => "754382" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22110999" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0225" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of pathological data between prostate biopsy and radical prostatectomy specimen in patients with low to very low risk prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Lendinez-Cano" 1 => "J. Alonso-Flores" 2 => "V. Beltran-Aguilar" 3 => "A. Cayuela" 4 => "S. Salazar-Otero" 5 => "J. Bachiller-Burgos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.acuro.2015.02.005" "Revista" => array:6 [ "tituloSerie" => "Actas Urol Esp" "fecha" => "2015" "volumen" => "39" "paginaInicial" => "482" "paginaFinal" => "487" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25895440" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0230" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Are PSA density and PSA density of the transition zone more accurate than PSA in predicting the pathological stage of clinically localized prostate cancer?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Giannarini" 1 => "C.A. Scott" 2 => "U. Moro" 3 => "B. Pertoldi" 4 => "C.A. Beltrami" 5 => "C. Selli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.urolonc.2007.04.002" "Revista" => array:6 [ "tituloSerie" => "Urol Oncol" "fecha" => "2008" "volumen" => "26" "paginaInicial" => "353" "paginaFinal" => "360" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18367100" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0235" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "PSA in the new millennium: a powerful predictor of prostate cancer prognosis and radical prostatectomy outcomes – results from the SEARCH database" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.J. Freedland" 1 => "J.M. Hotaling" 2 => "N.J. Fitzsimons" 3 => "J.C. Presti Jr." 4 => "C.J. Kane" 5 => "M.K. Terris" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eururo.2007.08.047" "Revista" => array:6 [ "tituloSerie" => "Eur Urol" "fecha" => "2008" "volumen" => "53" "paginaInicial" => "758" "paginaFinal" => "764" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17868976" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0240" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The digital rectal examination (DRE) remains important-outcomes from a contemporary cohort of men undergoing an initial 12-18 core prostate needle biopsy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Palmerola" 1 => "P. Smith" 2 => "V. Elliot" 3 => "C.T. Reese" 4 => "F.B. Mahon" 5 => "L.E. Harpster" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Canadian J Urol" "fecha" => "2012" "volumen" => "19" "paginaInicial" => "6542" "paginaFinal" => "6547" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0245" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cancer statistics, 2016" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.L. Siegel" 1 => "K.D. Miller" 2 => "A. Jemal" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "CA: Cancer J Clin" "fecha" => "2016" "volumen" => "66" "paginaInicial" => "7" "paginaFinal" => "30" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0250" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cancer statistics in China, 2015" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W. Chen" 1 => "R. Zheng" 2 => "P.D. Baade" 3 => "S. Zhang" 4 => "H. Zeng" 5 => "F. Bray" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "CA: Cancer J Clin" "fecha" => "2016" "volumen" => "66" "paginaInicial" => "115" "paginaFinal" => "132" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0255" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Active surveillance for prostate cancer: a systematic review of clinicopathologic variables and biomarkers for risk stratification" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Loeb" 1 => "S.M. Bruinsma" 2 => "J. Nicholson" 3 => "A. Briganti" 4 => "T. Pickles" 5 => "Y. Kakehi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eururo.2014.10.010" "Revista" => array:6 [ "tituloSerie" => "Eur Urol" "fecha" => "2015" "volumen" => "67" "paginaInicial" => "619" "paginaFinal" => "626" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25457014" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0260" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Active surveillance for clinically localized prostate cancer – a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F.B. Thomsen" 1 => "K. Brasso" 2 => "L.H. Klotz" 3 => "M.A. Roder" 4 => "K.D. Berg" 5 => "P. Iversen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jso.23584" "Revista" => array:6 [ "tituloSerie" => "J Surg Oncol" "fecha" => "2014" "volumen" => "109" "paginaInicial" => "830" "paginaFinal" => "835" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24610744" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0265" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multifocal prostate cancer: biologic, prognostic, and therapeutic implications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Andreoiu" 1 => "L. Cheng" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Human Pathol" "fecha" => "2010" "volumen" => "41" "paginaInicial" => "781" "paginaFinal" => "793" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0270" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Optimal approach for prostate cancer detection as initial biopsy: prospective randomized study comparing transperineal versus transrectal systematic 12-core biopsy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Hara" 1 => "Y. Jo" 2 => "T. Fujii" 3 => "N. Kondo" 4 => "T. Yokoyoma" 5 => "Y. Miyaji" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.urology.2007.09.029" "Revista" => array:6 [ "tituloSerie" => "Urology" "fecha" => "2008" "volumen" => "71" "paginaInicial" => "191" "paginaFinal" => "195" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18308081" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0275" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of image-guided targeted biopsies versus systematic randomized biopsies in the detection of prostate cancer: a systematic literature review of well-designed studies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. van Hove" 1 => "P.H. Savoie" 2 => "C. Maurin" 3 => "S. Brunelle" 4 => "G. Gravis" 5 => "N. Salem" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00345-014-1332-3" "Revista" => array:6 [ "tituloSerie" => "World J Urol" "fecha" => "2014" "volumen" => "32" "paginaInicial" => "847" "paginaFinal" => "858" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24919965" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0280" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of MR/ultrasound fusion-guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.M. Siddiqui" 1 => "S. Rais-Bahrami" 2 => "B. Turkbey" 3 => "A.K. George" 4 => "J. Rothwax" 5 => "N. Shakir" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.2014.17942" "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2015" "volumen" => "313" "paginaInicial" => "390" "paginaFinal" => "397" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25626035" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0285" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Magnetic resonance and ultrasound image fusion supported transperineal prostate biopsy using the ginsburg protocol: technique, learning points, and biopsy results" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Hansen" 1 => "G. Patruno" 2 => "K. Wadhwa" 3 => "G. Gaziev" 4 => "R. Miano" 5 => "T. Barrett" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Eur Urol" "fecha" => "2016" ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0290" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason grading of prostatic carcinoma: definition of grading patterns and proposal for a new grading system" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.I. Epstein" 1 => "L. Egevad" 2 => "M.B. Amin" 3 => "B. Delahunt" 4 => "J.R. Srigley" 5 => "P.A. Humphrey" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Sur Pathol" "fecha" => "2016" "volumen" => "40" "paginaInicial" => "244" "paginaFinal" => "252" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735786/0000004100000003/v1_201703250114/S2173578617300124/v1_201703250114/en/main.assets" "Apartado" => array:4 [ "identificador" => "6274" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735786/0000004100000003/v1_201703250114/S2173578617300124/v1_201703250114/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578617300124?idApp=UINPBA00004N"]

Statistics

Original article

Gleason sum upgrading between biopsy and radical prostatectomy in Chinese population: Updated nomograms

Infragradación de la biopsia de próstata respecto a la pieza de prostatectomía la población China: nomogramas actualizados

H. Xua, P.D. Baib, M.B. Hua, S.H. Maoa, W.H. Zhua, J.M. Hua, S.H. Liua, T. Yanga, J.Y. Houa, Y. Hua, Q. Dinga, H.W. Jianga,

Corresponding author

haowen_jiang@126.com

Corresponding author.

a Departamento de Urología, Hospital Huashan, Universidad Fudan, Shanghai, PR China

b Departamento de Urología, The First Affiliated Hospital of Xiamen University, Fujian, PR China

Read

Times
was read the article

Total PDF

Total HTML

Share statistics

 array:24 [
  "pii" => "S2173578617300124"
  "issn" => "21735786"
  "doi" => "10.1016/j.acuroe.2017.02.004"
  "estado" => "S300"
  "fechaPublicacion" => "2017-04-01"
  "aid" => "904"
  "copyright" => "AEU"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Actas Urol Esp. 2017;41:162-71"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 5
    "formatos" => array:2 [
      "HTML" => 4
      "PDF" => 1
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0210480616301097"
      "issn" => "02104806"
      "doi" => "10.1016/j.acuro.2016.04.015"
      "estado" => "S300"
      "fechaPublicacion" => "2017-04-01"
      "aid" => "904"
      "copyright" => "AEU"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Actas Urol Esp. 2017;41:162-71"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 49
        "formatos" => array:2 [
          "HTML" => 44
          "PDF" => 5
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Art&#237;culo original</span>"
        "titulo" => "Infragradaci&#243;n de la biopsia de pr&#243;stata respecto a la pieza de prostatectom&#237;a la poblaci&#243;n china&#58; nomogramas actualizados"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "162"
            "paginaFinal" => "171"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Gleason sum upgrading between biopsy and radical prostatectomy in Chinese population&#58; Updated nomograms"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 2105
                "Ancho" => 2546
                "Tamanyo" => 385950
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Nomograma para predecir la supragraduaci&#243;n patol&#243;gica de la suma de Gleason en las muestras de prostatectom&#237;a radical respecto a la muestra de biopsia en la cohorte principal&#46; A&#46; Gr&#225;fico de calibraci&#243;n de las probabilidades predichas y observadas de supragraduaci&#243;n de suma de Gleason en la cohorte principal &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>237&#41;&#46; La probabilidad predicha por el nomograma de supragraduaci&#243;n de suma de Gleason se representa en el eje X y la tasa observada de actualizaci&#243;n se representa en el eje Y&#46;</p> <p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">B&#46; Nomograma para predecir la supragraduaci&#243;n en las muestras de prostatectom&#237;a radical respecto a las muestra de biopsia&#46;</p> <p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">C&#46; Gr&#225;fico de calibraci&#243;n de las probabilidades predichas y observadas de la supragraduaci&#243;n de la suma de Gleason significativa en pacientes con suma de Gleason &#60;<span class="elsevierStyleHsp" style=""></span>8 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>193&#41;&#46; La predicci&#243;n calculada utilizando el nomograma se traza en el eje X&#44; y la tasa observada de supragraduaci&#243;n patol&#243;gica de suma de Gleason significativa se traza en el eje Y&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "H&#46; Xu, P&#46;D&#46; Bai, M&#46;B&#46; Hu, S&#46;H&#46; Mao, W&#46;H&#46; Zhu, J&#46;M&#46; Hu, S&#46;H&#46; Liu, T&#46; Yang, J&#46;Y&#46; Hou, Y&#46; Hu, Q&#46; Ding, H&#46;W&#46; Jiang"
            "autores" => array:12 [
              0 => array:2 [
                "nombre" => "H&#46;"
                "apellidos" => "Xu"
              ]
              1 => array:2 [
                "nombre" => "P&#46;D&#46;"
                "apellidos" => "Bai"
              ]
              2 => array:2 [
                "nombre" => "M&#46;B&#46;"
                "apellidos" => "Hu"
              ]
              3 => array:2 [
                "nombre" => "S&#46;H&#46;"
                "apellidos" => "Mao"
              ]
              4 => array:2 [
                "nombre" => "W&#46;H&#46;"
                "apellidos" => "Zhu"
              ]
              5 => array:2 [
                "nombre" => "J&#46;M&#46;"
                "apellidos" => "Hu"
              ]
              6 => array:2 [
                "nombre" => "S&#46;H&#46;"
                "apellidos" => "Liu"
              ]
              7 => array:2 [
                "nombre" => "T&#46;"
                "apellidos" => "Yang"
              ]
              8 => array:2 [
                "nombre" => "J&#46;Y&#46;"
                "apellidos" => "Hou"
              ]
              9 => array:2 [
                "nombre" => "Y&#46;"
                "apellidos" => "Hu"
              ]
              10 => array:2 [
                "nombre" => "Q&#46;"
                "apellidos" => "Ding"
              ]
              11 => array:2 [
                "nombre" => "H&#46;W&#46;"
                "apellidos" => "Jiang"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173578617300124"
          "doi" => "10.1016/j.acuroe.2017.02.004"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578617300124?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480616301097?idApp=UINPBA00004N"
      "url" => "/02104806/0000004100000003/v1_201703250108/S0210480616301097/v1_201703250108/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173578617300227"
    "issn" => "21735786"
    "doi" => "10.1016/j.acuroe.2017.02.014"
    "estado" => "S300"
    "fechaPublicacion" => "2017-04-01"
    "aid" => "920"
    "copyright" => "AEU"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Actas Urol Esp. 2017;41:172-80"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 3
      "HTML" => 3
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Expression of proteins FGFR3&#44; PI3K&#44; AKT&#44; p21Waf1&#47;Cip1 and cyclins D1 and D3 in patients with T1 bladder tumors&#58; Clinical implications and prognostic significance"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "172"
          "paginaFinal" => "180"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Expresi&#243;n de las prote&#237;nas FGFR3&#44; PI3K&#44; AKT&#44; p21Waf1&#47;Cip1 y ciclinas D1 y D3 en pacientes con tumores de vejiga T1&#58; implicaciones cl&#237;nicas y significado pron&#243;stico"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1574
              "Ancho" => 2168
              "Tamanyo" => 165494
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Scheme depicting the intracellular signaling pathway involving the biomarkers FGFR3&#44; PI3K&#44; AKT&#44; in addition to the cell cycle regulators p21 and cyclins D1 and D3&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46;M&#46; Blanca Pedregosa, &#193;&#46; S&#225;nchez-Gonz&#225;lez, J&#46; Carrasco Valiente, J&#46;M&#46; Ruiz Garc&#237;a, E&#46; G&#243;mez G&#243;mez, A&#46; L&#243;pez Beltr&#225;n, M&#46;J&#46; Requena Tapia"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "A&#46;M&#46;"
              "apellidos" => "Blanca Pedregosa"
            ]
            1 => array:2 [
              "nombre" => "&#193;&#46;"
              "apellidos" => "S&#225;nchez-Gonz&#225;lez"
            ]
            2 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Carrasco Valiente"
            ]
            3 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Ruiz Garc&#237;a"
            ]
            4 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "G&#243;mez G&#243;mez"
            ]
            5 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "L&#243;pez Beltr&#225;n"
            ]
            6 => array:2 [
              "nombre" => "M&#46;J&#46;"
              "apellidos" => "Requena Tapia"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210480616301322"
        "doi" => "10.1016/j.acuro.2016.09.003"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480616301322?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578617300227?idApp=UINPBA00004N"
    "url" => "/21735786/0000004100000003/v1_201703250114/S2173578617300227/v1_201703250114/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2173578617300112"
    "issn" => "21735786"
    "doi" => "10.1016/j.acuroe.2017.02.003"
    "estado" => "S300"
    "fechaPublicacion" => "2017-04-01"
    "aid" => "934"
    "copyright" => "AEU"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Actas Urol Esp. 2017;41:155-61"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 7
      "formatos" => array:2 [
        "HTML" => 5
        "PDF" => 2
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Higher number of transrectal ultrasound guided prostate biopsy cores is associated with higher blood loss and perioperative complications in robot assisted radical prostatectomy"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "155"
          "paginaFinal" => "161"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Un mayor n&#250;mero de cilindros de biopsia transrectal de pr&#243;stata guiada por ultrasonido se asocia con una mayor p&#233;rdida de sangre y complicaciones perioperatorias en la prostatectom&#237;a radical asistida por robot"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46; Carneiro, A&#46; Sivaraman, R&#46; Sanchez-Salas, I&#46; Nunes-Silva, M&#46; Baghdadi, V&#46; Srougi, E&#46; di Trapani, F&#46; Uriburu Pizzaro, S&#46; Doizi, E&#46; Barret, F&#46; Rozet, M&#46; Galiano, X&#46; Cathelineau"
          "autores" => array:13 [
            0 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Carneiro"
            ]
            1 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Sivaraman"
            ]
            2 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Sanchez-Salas"
            ]
            3 => array:2 [
              "nombre" => "I&#46;"
              "apellidos" => "Nunes-Silva"
            ]
            4 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Baghdadi"
            ]
            5 => array:2 [
              "nombre" => "V&#46;"
              "apellidos" => "Srougi"
            ]
            6 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "di Trapani"
            ]
            7 => array:2 [
              "nombre" => "F&#46; Uriburu"
              "apellidos" => "Pizzaro"
            ]
            8 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Doizi"
            ]
            9 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Barret"
            ]
            10 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Rozet"
            ]
            11 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Galiano"
            ]
            12 => array:2 [
              "nombre" => "X&#46;"
              "apellidos" => "Cathelineau"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210480616301590"
        "doi" => "10.1016/j.acuro.2016.09.012"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480616301590?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578617300112?idApp=UINPBA00004N"
    "url" => "/21735786/0000004100000003/v1_201703250114/S2173578617300112/v1_201703250114/en/main.assets"
  ]
  "en" => array:21 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Gleason sum upgrading between biopsy and radical prostatectomy in Chinese population&#58; Updated nomograms"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "162"
        "paginaFinal" => "171"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "H&#46; Xu, P&#46;D&#46; Bai, M&#46;B&#46; Hu, S&#46;H&#46; Mao, W&#46;H&#46; Zhu, J&#46;M&#46; Hu, S&#46;H&#46; Liu, T&#46; Yang, J&#46;Y&#46; Hou, Y&#46; Hu, Q&#46; Ding, H&#46;W&#46; Jiang"
        "autores" => array:12 [
          0 => array:3 [
            "nombre" => "H&#46;"
            "apellidos" => "Xu"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "P&#46;D&#46;"
            "apellidos" => "Bai"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "M&#46;B&#46;"
            "apellidos" => "Hu"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "S&#46;H&#46;"
            "apellidos" => "Mao"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "W&#46;H&#46;"
            "apellidos" => "Zhu"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "J&#46;M&#46;"
            "apellidos" => "Hu"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "S&#46;H&#46;"
            "apellidos" => "Liu"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "T&#46;"
            "apellidos" => "Yang"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "J&#46;Y&#46;"
            "apellidos" => "Hou"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          9 => array:3 [
            "nombre" => "Y&#46;"
            "apellidos" => "Hu"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          10 => array:3 [
            "nombre" => "Q&#46;"
            "apellidos" => "Ding"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          11 => array:4 [
            "nombre" => "H&#46;W&#46;"
            "apellidos" => "Jiang"
            "email" => array:1 [
              0 => "haowen&#95;jiang&#64;126&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Departamento de Urolog&#237;a&#44; Hospital Huashan&#44; Universidad Fudan&#44; Shanghai&#44; PR China"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Departamento de Urolog&#237;a&#44; The First Affiliated Hospital of Xiamen University&#44; Fujian&#44; PR China"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Infragradaci&#243;n de la biopsia de pr&#243;stata respecto a la pieza de prostatectom&#237;a la poblaci&#243;n China&#58; nomogramas actualizados"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2125
            "Ancho" => 2547
            "Tamanyo" => 360326
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Nomogram for predicting Gleason sum upgrading between biopsy and radical prostatectomy specimens in main cohort&#46; &#40;A&#41; Calibration plot of the predicted and observed probabilities of Gleason sum upgrading in the main cohort &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>237&#41;&#46; The nomogram-predicted probability of biopsy Gleason sum upgrading is plotted on the <span class="elsevierStyleItalic">X</span>-axis&#44; and the observed rate of upgrading is plotted on the <span class="elsevierStyleItalic">Y</span>-axis&#46; &#40;B&#41; Nomogram for predicting Gleason sum upgrading between biopsy and radical prostatectomy&#46; &#40;C&#41; Calibration plot of the predicted and observed probabilities of significant Gleason sum upgrading in patients with Gleason sum<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>8 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>193&#41;&#46; The prediction calculated using the nomogram is plotted on the <span class="elsevierStyleItalic">X</span>-axis&#44; and the observed rate of significant Gleason sum upgrading is plotted on the <span class="elsevierStyleItalic">Y</span>-axis&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Prostate adenocarcinoma is the most common prostate cancer&#46; In clinical practice&#44; prostate adenocarcinoma is graded by the Gleason system&#44; which was developed in 1966 by Dr Donald Gleasonm&#44;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a> a pathologist from Minneapolis&#44; USA&#46; Using low-power microscopy&#44; prostate adenocarcinoma is graded from 1 to 5 according to its gland-forming differentiation&#46; Both specimens from prostate biopsy and radical prostatectomy &#40;RP&#41; will be graded with a certain Gleason score &#40;GS&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">However&#44; previous researches indicated that there existed the possibility of mismatch of GS after RP compared with biopsy&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">2&#44;3</span></a> Approximately one third of patients would have a diagnosis of more aggressive prostate adenocarcinoma with a higher GS at RP than was diagnosed at biopsy&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">4&#8211;6</span></a> In clinical practice&#44; GS is one of the most important parameters for consideration when urologists offer the suitable treatment choices to the patient&#46; The change of GS after RP&#44; especially upgrading of GS&#44; might alter the treatment option&#44; since some surgical interventions would have been avoided if patients were diagnosed with high-risk prostate adenocarcinoma at biopsy&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In order to avoid overtreatment caused by Gleason sum &#40;sumGS&#41; upgrading between RP and biopsy&#44; several models have been developed to predict the probability of sumGS upgrading in European or American patients in the last decade&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">5&#44;6</span></a> These models were designed to reduce unnecessary surgeries and make more economic-effective treatment decisions&#46; PSA screening is widely practiced in western countries&#44; and the mean PSA value of these studies was mostly less than 10<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#46; However&#44; PSA screening is not as widely carried out in China as in western countries&#44; which leads to the fact that quite a few patients have a relatively higher PSA value at diagnosis&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Last year&#44; Wang et al&#46; carried out the first study aiming to build a nomogram for the prediction of SumGS upgrading in prostate adenocarcinoma in the Chinese population&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">4</span></a> Patients included in that study were admitted due to clinical symptoms such as urinary frequency&#44; urgency&#44; dysuria&#44; and hematuria from 2006 to 2011&#46; However&#44; since PSA screening is becoming popular and widely accepted in China&#44; more and more patients referred to the hospital for further examination due to elevated PSA value&#46; We would like to build a new nomogram based on the database of the last five years in our center&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Patient population</span><p id="par0025" class="elsevierStylePara elsevierViewall">Between February 2011 and May 2015&#44; 260 consecutive patients received RP at the Huashan Hospital&#44; Fudan University&#46; All patients were ethnic Han Chinese&#44; who were informed about the aims and requirements of this study&#46; Informed consent for participation was obtained in accordance with institutional guidance at Huashan Hospital&#46; Clinical and pathological data were retrospectively gathered&#46; All these patients had biopsy-proven prostate adenocarcinoma&#46; Of these&#44; 188 patients received biopsy at our hospital&#46; Their specimens were directly sent to the Pathology Department of our hospital&#46; The rest of the patients received biopsy in other hospitals&#44; and their biopsy sections were re-examined by pathologists from our hospital&#46; Prostate adenocarcinoma grading was made according to the 2005 International Society of Urological Pathology &#40;ISUP&#41; consensus conference on Gleason grading of prostatic carcinoma&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">7</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Overall&#44; 23 patients were excluded&#46; 16 patients were excluded because of missing data &#40;clinical stage&#44; PSA&#44; primary or secondary biopsy GS&#44; primary or secondary pathologic GS&#41;&#44; and 7 patients were excluded because no prostate adenocarcinoma was detected after RP&#46; A total of 237 evaluable patients were included in the analysis&#46; Of these&#44; 6 patients &#40;2&#46;53&#37;&#41; had clinical stage T3 prostate cancer&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Clinical and pathologic evaluation</span><p id="par0035" class="elsevierStylePara elsevierViewall">Patients&#8217; height and weight were recorded when they were admitted to our hospital for RP&#46; Body-mass index &#40;BMI&#41; was calculated accordingly&#46; Clinical stage was assigned by the attending urologist according to the 2009 TNM system&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">8</span></a> All these patients had pre-operative computed tomography &#40;CT&#41; or magnetic resonance imaging &#40;MRI&#41; for local and lymph nodes staging&#44; and bone scan or positron emission computed tomography &#40;PET-CT&#41; for distal staging&#46; 10-core biopsy was applied under transrectal ultrasound &#40;TRUS&#41; guidance&#46; Pre-operative PSA was measured before digital rectal examination &#40;DRE&#41; and TRUS&#46; Some patients already had PSA results in outpatient clinic&#46; All prostatectomy specimens were also graded according to the Gleason system&#46; No patient received neoadjuvant androgen therapy&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analyses</span><p id="par0040" class="elsevierStylePara elsevierViewall">The main outcome of our study was sumGS upgrading between biopsy and RP pathology&#46; In order to explore potential predictors of sumGS upgrading&#44; we applied age&#44; BMI&#44; PSA&#44; DRE results&#44; clinical T stage&#44; primary and secondary biopsy Gleason scores&#44; as well as sumGS in univariate and multivariate logistic regression models&#46; The prediction model was further evaluated for its ability to predict significant upgrading in patients with biopsy sumGS<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>8&#46; The statistical performance of the prediction model was assessed by both discrimination and calibration ability&#46; Discrimination ability was measured using the concordance index &#40;<span class="elsevierStyleItalic">C</span>-index&#41;&#46; Bootstrap-corrected <span class="elsevierStyleItalic">C</span>-indexes were further calculated to better estimate expected future predictive accuracy&#46; Calibration ability was assessed by both calibration plot of predicted probability of sumGS upgrading versus actual outcomes and by the Spiegelhalter <span class="elsevierStyleItalic">Z</span>-test&#46; All statistical tests were performed using SPSS version 19&#46;0 and software R 2&#46;11&#46;1&#46; Moreover&#44; all tests were two-sided with a significance level at 0&#46;05&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Basic and clinical data</span><p id="par0045" class="elsevierStylePara elsevierViewall">Patient characteristics are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Among all the 237 patients included&#44; the mean age was 67&#46;8 &#40;median&#58; 67&#44; range&#58; 47&#8211;86&#41;&#44; the mean BMI was 23&#46;76<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> &#40;median&#58; 23&#46;66<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#44; range&#58; 16&#46;07&#8211;31&#46;80<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#44; and the mean pre-operative PSA level was 19&#46;23<span class="elsevierStyleHsp" style=""></span>ng&#47;mL &#40;median&#58; 13&#46;43<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#44; range&#58; 1&#46;00&#8211;293&#46;30<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#41;&#46; Of these&#44; 176 patients had prostate volume data measured by TRUS with a mean volume of 38&#46;18<span class="elsevierStyleHsp" style=""></span>mL &#40;median&#58; 36<span class="elsevierStyleHsp" style=""></span>mL&#44; range&#58; 12&#8211;98<span class="elsevierStyleHsp" style=""></span>mL&#41;&#44; and 67 patients &#40;28&#46;27&#37;&#41; had abnormal digital rectal examination&#46; PSA values over 20<span class="elsevierStyleHsp" style=""></span>ng&#47;mL were recorded in 69 patients &#40;29&#46;11&#37;&#41; and 76 &#40;32&#46;07&#37;&#41; had PSA values below 20<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#46; Clinical stage T1 accounted for 123 patients &#40;51&#46;90&#37;&#41;&#44; and T2 accounted for 108 patients &#40;45&#46;57&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Among the 237 patients&#44; 115 &#40;48&#46;52&#37;&#41; had standardized biopsy data including number of positive cores and positive side data&#46; Of these patients&#44; the mean age was 68&#46;1 years old &#40;median&#58; 67&#44; range&#58; 55&#8211;83&#41;&#44; the mean BMI was 24&#46;17<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> &#40;median&#58; 23&#46;83<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#44; range&#58; 17&#46;23&#8211;31&#46;80<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#44; and the mean pre-operative PSA level was 16&#46;98<span class="elsevierStyleHsp" style=""></span>ng&#47;mL &#40;median&#58; 12&#46;44<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#44; range&#58; 3&#46;47&#8211;52&#46;53<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#41;&#46; Among this sub-cohort&#44; 89 patients had prostate volume data measured by TRUS with a mean volume of 37&#46;94<span class="elsevierStyleHsp" style=""></span>mL &#40;median&#58; 37<span class="elsevierStyleHsp" style=""></span>mL&#44; range&#58; 13&#8211;75<span class="elsevierStyleHsp" style=""></span>mL&#41;&#44; and abnormal digital rectal examination was observed in 46 patients &#40;28&#46;27&#37;&#41;&#46; PSA values over 20<span class="elsevierStyleHsp" style=""></span>ng&#47;mL were recorded in 34 patients &#40;29&#46;57&#37;&#41; and 33 &#40;28&#46;70&#37;&#41; had PSA values below 20<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#46; Clinical stage T1 accounted for 65 patients &#40;56&#46;52&#37;&#41;&#44; and T2 accounted for 46 patients &#40;40&#46;00&#37;&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Pathological data</span><p id="par0055" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> showed pathological data of biopsy and RP in both the main cohort and the sub-cohort&#46; We also listed the details of Gleason score of both biopsy and RP &#40;see Appendix A&#41;&#46; In the main cohort&#44; upgrading was recorded in 62 &#40;26&#46;16&#37;&#41;&#44; whereas 10&#46;97&#37; were downgraded&#46; The same sumGS at biopsy and pathology was found in 149 &#40;62&#46;87&#37;&#41;&#46; And in the sub-cohort&#44; upgrading was recorded in 31 &#40;26&#46;96&#37;&#41;&#44; whereas 12&#46;17&#37; were downgraded&#46; The same sumGS at biopsy and pathology was found in 70 &#40;60&#46;87&#37;&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Nomogram development</span><p id="par0060" class="elsevierStylePara elsevierViewall">In the main cohort&#44; pre-operative PSA level&#44; DRE abnormality&#44; clinical T stage&#44; secondary GS and sumGS were significant predictors of sumGS upgrading between biopsy and final pathology in univariate analysis&#46; These variables were then included in multivariate analysis&#46; As shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#44; DRE abnormality &#91;OR&#58; 2&#46;133&#44; 95&#37; confidence interval &#40;CI&#41;&#58; 0&#46;912&#8211;4&#46;987&#44; <span class="elsevierStyleItalic">P</span>&#58; 0&#46;08&#93; was moderately significant and was added to the model for assessment&#44; together with two significant predictors&#44; namely pre-operative PSA level &#40;OR&#58; 1&#46;06&#44; 95&#37; CI&#58; 1&#46;033&#8211;1&#46;088&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and biopsy sumGS &#40;OR&#58; 0&#46;421&#44; 95&#37; CI&#58; 0&#46;220&#8211;0&#46;804&#44; <span class="elsevierStyleItalic">P</span>&#58; 0&#46;009&#41;&#46; The <span class="elsevierStyleItalic">C</span>-index was 0&#46;798&#44; and the bootstrap-corrected <span class="elsevierStyleItalic">C</span>-index was 0&#46;787&#46; The calibration plot demonstrated that the rate of predicted sumGS upgrading paralleled the observed rate well &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#46; Based on these results from the main cohort&#44; a nomogram was constructed to predict sumGS upgrading in a user-friendly manner &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#46; To investigate the nomogram&#39;s ability to predict significant upgrading&#44; we used it to evaluate 193 patients with biopsy sumGS<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>8&#46; In this validation group&#44; 56 &#40;29&#46;02&#37;&#41; patients had sumGS upgrading&#46; The prediction model showed a good discrimination ability &#40;<span class="elsevierStyleItalic">C</span>-index&#58; 0&#46;788&#41;&#44; and the Spiegelhalter <span class="elsevierStyleItalic">Z</span>-test indicated good calibration &#40;<span class="elsevierStyleItalic">P</span>&#58; 0&#46;909&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Since the number of positive cores and whether these cores were bilateral or unilateral were also important to predict sumGS upgrading&#44; we tried to draw the preliminary nomogram based on the sub-cohort&#46; In the sub-cohort&#44; pre-operative PSA level&#44; secondary GS&#44; sumGS&#44; number of positive cores&#44; and positive side were significant predictors of sumGS upgrading between biopsy and final pathology in univariate analysis&#46; These variables were then included in multivariate analysis&#46; Number of positive cores &#40;OR&#58; 1&#46;025&#44; 95&#37; CI&#58; 0&#46;996&#8211;1&#46;054&#44; <span class="elsevierStyleItalic">P</span>&#58; 0&#46;088&#41; was moderately significant and was added to the model for assessment&#44; together with two significant predictors&#44; namely pre-operative PSA level &#40;OR&#58; 1&#46;072&#44; 95&#37; CI&#58; 1&#46;015&#8211;1&#46;132&#44; <span class="elsevierStyleItalic">P</span>&#58; 0&#46;012&#41; and biopsy sumGS &#40;OR&#58; 0&#46;181&#44; 95&#37; CI&#58; 0&#46;059&#8211;0&#46;577&#44; <span class="elsevierStyleItalic">P</span>&#58; 0&#46;003&#41;&#46; The <span class="elsevierStyleItalic">C</span>-index was 0&#46;883 and the bootstrap-corrected <span class="elsevierStyleItalic">C</span>-index was 0&#46;833&#46; The calibration plot demonstrated that the rate of predicted sumGS upgrading paralleled the observed rate well &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#41;&#46; Based on these results&#44; another nomogram was also constructed &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41;&#46; To investigate the nomogram&#39;s ability to predict significant upgrading&#44; we used it to evaluate 95 patients with biopsy SumGS<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>8&#46; In this validation group&#44; 30 &#40;31&#46;58&#37;&#41; patients had sumGS upgrading&#46; The prediction model showed a good discrimination ability &#40;<span class="elsevierStyleItalic">C</span>-index&#58; 0&#46;825&#41;&#44; and the Spiegelhalter <span class="elsevierStyleItalic">Z</span>-test indicated good calibration &#40;<span class="elsevierStyleItalic">P</span>&#58; 0&#46;918&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>C&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">Based on our main cohort&#44; we successfully developed and validated a model to predict sumGS upgrading from biopsy to final pathology using three clinical variables &#40;pre-operative PSA level&#44; DRE abnormality&#44; and biopsy sumGS&#41;&#46; Our model is 78&#46;7&#37; accurate&#44; and its prediction approximated the observed rate quite well&#46; Meanwhile&#44; this prediction model showed good discrimination ability for significant upgrading&#44; with a <span class="elsevierStyleItalic">C</span>-index of 0&#46;788&#46; Since the number or percentage of positive cores were also related to sumGS upgrading&#44;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">9</span></a> we included both number of positive cores and positive side in our sub-analysis&#46; The preliminary nomogram included three clinical variables &#40;pre-operative PSA level&#44; number of positive cores&#44; and biopsy sumGS&#41;&#46; This preliminary model is 83&#46;3&#37; accurate&#44; with good prediction capacity&#46; It also presents good discrimination ability for significant upgrading&#44; with a <span class="elsevierStyleItalic">C</span>-index of 0&#46;825&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">In clinical practice&#44; GS is one of the most important measures in choosing the suitable treatment options and closely related to patients&#8217; prognosis&#46; It is important to have a better understanding of the possibility of sumGS upgrading after RP as well as the potential risk factors of sumGS upgrading&#46; In the last decade&#44; several western studies<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">6&#44;10&#8211;13</span></a> took the lead in designing a visible and user-friendly manner to help us predict the possibility of sumGS upgrading&#46; Serum PSA level&#44; biopsy sumGS&#44; number or percentage of positive cores&#44; maximum percentage of cancer per core&#44; prostate weight&#44; and age were potential significant predictors of sumGS upgrading after RP&#46; Much fewer studies had been carried out in Asian population&#46; The first external validation of western-edition nomogram in Asian population was performed in 2010 in Japan&#44; which was performed by Imamoto et al&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">14</span></a> by using the published model designed by Chun et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a> The following year&#44; in 2011&#44; Imamoto et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">15</span></a> produced a Japanese own nomogram for predicting sumGS upgrading between biopsy and RP&#46; The first external validation of western-edition nomogram in China was carried out in 2014 by Wang et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">4</span></a> and he also produced a new nomogram to predict sumGS upgrading in patients with clinically diagnosed prostate cancer&#46; Patients included in the study by Wang et al&#46; were admitted due to clinical symptoms from 2006 to 2011&#46; However&#44; since PSA screening is becoming more and more widely performed in China&#44; more and more patients referred to the hospital for further examination due to elevated PSA value&#46; Due to this transition and change&#44; our updated study would provide new insight into the sumGS upgrading between biopsy and RP in Chinese population&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The prevalence of sumGS upgrading in our main cohort was 26&#46;16&#37;&#44; which is within the range of previously reported values&#46; Interestingly&#44; one latest study carried out by Lend&#237;nez-Cano et al&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">16</span></a> found that&#44; even though 18&#46;4&#37; low-risk prostate adenocarcinoma patients had sumGS upgrading&#44; only 3&#46;8&#37; very low risk patients &#40;cT1c-T2a&#44; PSA<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#44; GS<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>6&#44; affected cores<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>3 and PSA density<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#46;15&#41; had sumGS upgrading&#44; indicating that very low risk prostate adenocarcinoma patients had less bad histological prognosis&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">In consistency with other studies&#44; pre-operative PSA level and biopsy sumGS were significant predictors of sumGS upgrading between biopsy and RP in our main cohort&#46; The mean PSA value was 19&#46;23<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#44; which was comparable with that in the study by Wang et al&#46; &#40;19&#46;7<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">4</span></a> but it was much higher than that in the study by Imamoto et al&#46; &#40;13&#46;977<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#41;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">15</span></a> and in the study by Chun et al&#46; &#40;9&#46;6<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a> Serum PSA level is crucially associated with local stage<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">17</span></a> and prognosis<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">18</span></a> of prostate adenocarcinoma&#46; Together with its close relationship with sumGS upgrading&#44; there was no doubt of PSA&#39;s great importance in prostate adenocarcinoma evaluation and assessment&#46; We failed to observe a significant decrease in PSA level compared to the study by Wang et al&#46;&#44; which indicates that a majority of patients already had high-risk prostate adenocarcinoma at diagnosis in China&#44; although PSA screening seemed to be more widely performed&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Besides PSA level&#44; DRE is suggested to be performed routinely in urology clinic&#44; which helps detect early prostate cancer&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">19</span></a> In our univariate analysis&#44; DRE &#40;<span class="elsevierStyleItalic">P</span>&#58; 0&#46;006&#41; was significantly associated with sumGS upgrading&#44; which failed to remain a significant predictor in further multivariate analysis &#40;<span class="elsevierStyleItalic">P</span>&#58; 0&#46;080&#41;&#46; We included DRE in nomogram development due to its promising result and vital clinical meaning&#46; However&#44; when reviewing related studies published before&#44; we hardly found DRE abnormality in the final nomogram&#46; One of the possible explanations might be that the patients in our study had larger tumor nodules than those in other studies due to relatively delayed diagnosis&#44; which was consistent with significantly higher PSA level in our study&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">In our study&#44; 122 patients had missing data about standardized biopsy details of each core&#46; So we carried out a sub-analysis of the remaining 115 patients and found that the number of positive cores was significantly associated with sumGS upgrading in univariate analysis &#40;<span class="elsevierStyleItalic">P</span>&#58; 0&#46;041&#41;&#44; but it was moderately significant in multivariate analysis &#40;<span class="elsevierStyleItalic">P</span>&#58; 0&#46;088&#41;&#46; Whether the lesion was bilateral or unilateral in the biopsy seemed not to be associated to sumGS upgrading in multivariate analysis &#40;<span class="elsevierStyleItalic">P</span>&#58; 0&#46;267&#41;&#46; Both number of positive cores and positive side were related to local stage at biopsy&#46; Both Japanese-edition<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">15</span></a> and western-edition nomogram<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a> included T stage as a significant predictor&#46; Although our study revealed a significant association between T stage and sumGS upgrading &#40;<span class="elsevierStyleItalic">P</span>&#58; 0&#46;038&#41;&#44; it failed to remain significant in multivariate analysis &#40;<span class="elsevierStyleItalic">P</span>&#58; 0&#46;336&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Prostate adenocarcinoma grading&#44; especially biopsy GS&#44; was used in risk stratification&#44; and influenced further treatment options&#46; Prostate adenocarcinoma is the most common cancer in the United States and it alone is predicted to account for 1 in 5 new diagnoses in 2016&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">20</span></a> In order to avoid overtreatment of prostate adenocarcinoma&#44; several models have been developed to predict the probability of sumGS upgrading in western patients&#46; However&#44; the incidence of prostate adenocarcinoma is much lower in China&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">21</span></a> Different genetic background as well as lifestyle and environment exposure might explain the difference&#44; but less popular PSA screening and public awareness of prostate adenocarcinoma might also contribute to the giant gap&#46; As a result&#44; the treatment strategy of prostate adenocarcinoma in China might be somehow more active and aggressive compared toWestern countries&#46; Those patients with a GS<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>6&#44; as well as stage T1c or T2a&#44; PSA<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#44; and age<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>70&#44; or a GS<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>7 and age<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>70&#44; were candidates for active surveillance&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">22&#44;23</span></a> However&#44; taking into account that quite a few patients would encounter Gleason upgrading after RP &#40;our study showed that more than one fourth of patients were diagnosed with upgrading GS after RP&#41;&#44; risk existed that a higher Gleason grade prostate adenocarcinoma was missed in biopsy&#46; In such cases&#44; active surveillance might postpone the curative treatment&#46; RP or radiotherapy might be more appropriate for those low-risk patients but who have great potential Gleason upgrading&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The main cause of the relative low matching ratio between biopsy and RP GS was that most prostate adenocarcinoma cases are multifocal&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">24</span></a> Although it was guided by TRUS&#44; the detection rate was often lower than 50&#37;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">25</span></a> and many aggressive cancers were missed&#46; In order to improve the detection rate&#44; new sonographic modalities such as sonoelastography and contrast-enhanced ultrasound have being investigated&#46; But no clear advantage of these targeted biopsies over the current standard of systematic 10&#8211;12 core biopsy schemes was observed&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">26</span></a> Besides&#44; the use of multiparametric magnetic resonance imaging &#40;mpMRI&#41; and ultrasound image fusion-guided targeted biopsy has increased&#46; Both MRI&#47;TRUS image fusion guided transrectal<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">27</span></a> and transperineal<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">28</span></a> prostate biopsy detect more clinically significant GS 7&#8211;10 cancers and fewer insignificant GS 6 cancers than TRUS guided biopsy&#46; The wide use of MRI&#47;TRUS image fusion guided prostate biopsy might increase the matching ratio between biopsy and RP GS&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Our study was designed to assess the risk factors of sumGS upgrading between biopsy and RP in the last five years when PSA screening was becoming relatively more widely performed in China&#46; Our nomograms had acceptable accuracy and worked well&#46; But several limitations have to be considered&#46; First&#44; both DRE abnormality and number of positive cores&#44; despite being included in nomogram development&#44; were not significant predictors&#44; owing to limited sample size&#46; We are going to continue the study prospectively and further assess these variables on a larger scale based on their potential shown in our present study&#46; Second&#44; although all the patients included underwent 10-core biopsy&#44; they had inconsistent biopsy details since some of them received biopsy at other hospitals&#46; In the future&#44; we are going to apply the standardized biopsy report format in our hospital&#44; which would provide more comparable indicators&#46; Third&#44; there have been many changes about Gleason&#39;s recommendations between the 2005 grading conference and the 2014 conference&#46; According to both the 2014 International Society of Urological Pathology &#40;ISUP&#41; consensus conference on Gleason grading of prostatic carcinoma<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">29</span></a> and 2016 European Association of Urology Guidelines on Prostate Cancer&#44; sumGS<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>6 was classified as Gleason group 1&#46; The new Gleason classification might provide more accurate stratification of tumors than the current system&#46; In a future study&#44; we would apply the new Gleason classification system and try to validate its use in Chinese population&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conclusion</span><p id="par0115" class="elsevierStylePara elsevierViewall">Pre-operative PSA level and biopsy Gleason sum were significant predictors of Gleason sum upgrading between biopsy and RP&#46; DRE result and number of positive cores were also respectively included in the two models for their moderate significance and important clinical meaning&#46; User-friendly nomograms to predict Gleason sum upgrading in Chinese population were developed&#44; demonstrating good statistical performance upon internal validation&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Funding</span><p id="par0120" class="elsevierStylePara elsevierViewall">This study was sponsored by the <span class="elsevierStyleGrantSponsor" id="gs1">National Natural Science Foundation of China</span> &#40;No&#46; <span class="elsevierStyleGrantNumber" refid="gs1">81272835</span>&#41;&#44; the <span class="elsevierStyleGrantSponsor" id="gs2">Program for New Century Excellent Talents in University</span>&#44; China &#40;<span class="elsevierStyleGrantNumber" refid="gs2">NCET-13-0136</span>&#41;&#44; the <span class="elsevierStyleGrantSponsor" id="gs3">Shanghai Education Committee Scientific Research Innovation Project</span>&#44; China &#40;<span class="elsevierStyleGrantNumber" refid="gs3">No&#46; 14ZZ010</span>&#41;&#44; and the <span class="elsevierStyleGrantSponsor" id="gs4">Shanghai Talent Development Foundation</span> &#40;No&#46; <span class="elsevierStyleGrantNumber" refid="gs4">201302</span>&#41;&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflict of interest</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres820141"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec817073"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres820140"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec817072"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Patient population"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Clinical and pathologic evaluation"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Statistical analyses"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0030"
          "titulo" => "Results"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Basic and clinical data"
            ]
            1 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Pathological data"
            ]
            2 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Nomogram development"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Conclusion"
        ]
        9 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Funding"
        ]
        10 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Conflict of interest"
        ]
        11 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-02-22"
    "fechaAceptado" => "2016-04-28"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec817073"
          "palabras" => array:5 [
            0 => "Biopsy"
            1 => "Gleason score"
            2 => "Nomogram"
            3 => "Prostate adenocarcinoma"
            4 => "Radical prostatectomy"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec817072"
          "palabras" => array:5 [
            0 => "Biopsia"
            1 => "Puntuaci&#243;n de Gleason"
            2 => "Nomograma"
            3 => "Adenocarcinoma de pr&#243;stata"
            4 => "Prostatectom&#237;a radical"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To assess the risk factors of Gleason sum upgrading between biopsy and radical prostatectomy &#40;RP&#41; and update the nomogram for the prediction of Gleason sum upgrading&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The study cohort consisted of 237 Chinese prostate adenocarcinoma patients who underwent 10-core prostate biopsy and subsequently received RP in Huashan Hospital from February 2011 to May 2015&#46; The main outcome of our study was Gleason sum upgrading between biopsy and RP pathology&#46; Univariate and multivariate logistic regression models were conducted to explore the potential predictors&#44; and ultimately to build the nomograms&#46; The prediction model was further evaluated for its ability to predict significant upgrading in patients with biopsy Gleason sum<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>8&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">In the main cohort of all the patients&#44; Gleason sum upgrading was observed in 62 &#40;26&#46;16&#37;&#41; patients&#46; The pre-operative prostate-specific antigen &#40;PSA&#41; level&#44; biopsy Gleason sum&#44; and digital rectal examination were used in building the nomogram&#44; which was validated internally with a bootstrap-corrected concordance index of 0&#46;787&#46; In the sub-cohort of 115 patients with standardized biopsy details&#44; Gleason sum upgrading was observed in 31 &#40;26&#46;96&#37;&#41; patients&#46; The pre-operative PSA level&#44; biopsy Gleason sum&#44; and number of positive cores were used in the nomogram&#44; which was also validated internally with a bootstrap-corrected concordance index of 0&#46;833&#46; These two nomograms both demonstrated satisfactory statistical performance for predicting significant upgrading&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Updated nomograms to predict Gleason sum upgrading in Chinese population between biopsy and RP were developed&#44; demonstrating good statistical performance upon internal validation&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Evaluar los factores de riesgo de la supragraduaci&#243;n de la suma de Gleason en la prostatectom&#237;a radical &#40;PR&#41; y actualizar el nomograma para la predicci&#243;n de la infragraduaci&#243;n de la biopsia respecto a la pieza de prostatectom&#237;a radical&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La cohorte del estudio consisti&#243; en 237 pacientes chinos con adenocarcinoma de pr&#243;stata que fueron sometidos a biopsia de pr&#243;stata de 10 cilindros y posteriormente fueron sometidos PR en el Hospital Huashan&#44; entre febrero de 2011 y mayo de 2015&#46; El principal objetivo de nuestro estudio fue el estudio de la supragraduaci&#243;n de la suma de Gleason respecto a la biopsia en la muestra de PR&#46; Se realizaron modelos de regresi&#243;n log&#237;stica univariante y multivariante para explorar los potenciales factores predictivos&#44; y en &#250;ltima instancia para construir los nomogramas&#46; El modelo de predicci&#243;n se evalu&#243; por su capacidad para predecir la supragraduaci&#243;n significativa en pacientes con suma de Gleason de biopsia &#60;<span class="elsevierStyleHsp" style=""></span>8&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">En la cohorte principal se observ&#243; supragraduaci&#243;n de la suma de Gleason en 62 &#40;26&#44;16&#37;&#41; pacientes&#46; El nivel de ant&#237;geno espec&#237;fico de pr&#243;stata &#40;PSA&#41; preoperatorio&#44; la suma de Gleason de biopsia y el tacto rectal se utilizaron en la construcci&#243;n del nomograma&#44; que fue validado internamente con un &#237;ndice de concordancia corregido por bootstrap de 0&#44;787&#46; En la subcohorte de 115 pacientes con datos estandarizados de biopsia se observ&#243; supragraduaci&#243;n en 31 &#40;26&#44;96&#37;&#41; pacientes&#46; El nivel preoperatorio de PSA&#44; suma de Gleason de biopsia y el n&#250;mero de cilindros positivos se utilizaron en el nomograma&#44; que tambi&#233;n fue validado internamente con un &#237;ndice de concordancia de corregido por bootstrap de 0&#44;833&#46; Estos 2 nomogramas demostraron un rendimiento estad&#237;stico satisfactorio para predecir supragraduaci&#243;n significativa&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se desarrollaron nomogramas actualizados para predecir la supragraduaci&#243;n de la suma de Gleason de la biopsia respecto a la PR&#44; que demostraron un buen rendimiento estad&#237;stico tras la validaci&#243;n interna&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Xu H&#44; Bai PD&#44; Hu MB&#44; Mao SH&#44; Zhu WH&#44; Hu JM&#44; et al&#46; Infragradaci&#243;n de la biopsia de pr&#243;stata respecto a la pieza de prostatectom&#237;a la poblaci&#243;n China&#58; nomogramas actualizados&#46; Actas Urol Esp&#46; 2017&#59;41&#58;162&#8211;171&#46;</p>"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0135" class="elsevierStylePara elsevierViewall">The following is the supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0075"
          ]
        ]
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2125
            "Ancho" => 2547
            "Tamanyo" => 360326
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Nomogram for predicting Gleason sum upgrading between biopsy and radical prostatectomy specimens in main cohort&#46; &#40;A&#41; Calibration plot of the predicted and observed probabilities of Gleason sum upgrading in the main cohort &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>237&#41;&#46; The nomogram-predicted probability of biopsy Gleason sum upgrading is plotted on the <span class="elsevierStyleItalic">X</span>-axis&#44; and the observed rate of upgrading is plotted on the <span class="elsevierStyleItalic">Y</span>-axis&#46; &#40;B&#41; Nomogram for predicting Gleason sum upgrading between biopsy and radical prostatectomy&#46; &#40;C&#41; Calibration plot of the predicted and observed probabilities of significant Gleason sum upgrading in patients with Gleason sum<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>8 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>193&#41;&#46; The prediction calculated using the nomogram is plotted on the <span class="elsevierStyleItalic">X</span>-axis&#44; and the observed rate of significant Gleason sum upgrading is plotted on the <span class="elsevierStyleItalic">Y</span>-axis&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 2071
            "Ancho" => 2543
            "Tamanyo" => 361465
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Nomogram for predicting Gleason sum upgrading between biopsy and radical prostatectomy specimens in sub-cohort&#46; &#40;A&#41; Calibration plot of the predicted and observed probabilities of Gleason sum upgrading in the sub-cohort &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>115&#41;&#46; The nomogram-predicted probability of biopsy Gleason sum upgrading is plotted on the <span class="elsevierStyleItalic">X</span>-axis&#44; and the observed rate of upgrading is plotted on the <span class="elsevierStyleItalic">Y</span>-axis&#46; &#40;B&#41; Nomogram for predicting Gleason sum upgrading between biopsy and radical prostatectomy&#46; &#40;C&#41; Calibration plot of the predicted and observed probabilities of significant Gleason sum upgrading in patients with Gleason sum<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>8 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>95&#41;&#46; The prediction calculated using the nomogram is plotted on the <span class="elsevierStyleItalic">X</span>-axis&#44; and the observed rate of significant Gleason sum upgrading is plotted on the <span class="elsevierStyleItalic">Y</span>-axis&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:2 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age &#40;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Main cohort&#58; all patients &#40;237&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sub-cohort&#58; patients with detailed biopsy data &#40;115&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Median&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Range&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&#8211;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&#8211;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">BMI &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Median&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&#46;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&#46;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Range&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#46;07&#8211;31&#46;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#46;23&#8211;31&#46;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Prostate volume &#40;TRUS&#41; &#40;mL&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37&#46;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Median&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Range&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#8211;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#8211;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Missing data &#40;<span class="elsevierStyleItalic">N</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Pre-operative PSA &#40;ng&#47;mL&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#46;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Median&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Range&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;00&#8211;293&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;47&#8211;52&#46;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1378537.png"
              ]
            ]
            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span> &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span>&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DRE abnormality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">PSA &#40;ng&#47;mL&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>10&#8211;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#46;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">237&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Clinical stage</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>T1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">123&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51&#46;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&#46;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>T2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">108&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>T3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">237&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Primary biopsy Gleason</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">157&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#46;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">237&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Secondary biopsy Gleason</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">122&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#46;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">237&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Biopsy Gleason sum</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#46;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">237&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Primary pathological Gleason</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">157&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">237&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Secondary pathological Gleason</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">102&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&#46;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">237&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Pathological Gleason sum</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">116&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&#46;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&#46;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#46;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">237&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gleason sum upgrading&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1378539.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Basic clinical and pathological characteristics of patients&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:2 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="9" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Main cohort &#40;237&#41;</th></tr><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Univariate model</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Multivariate model</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">B</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">B</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pre-operative PSA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;034&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;035&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;014&#8211;1&#46;056&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;058&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;033&#8211;1&#46;088&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;981&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;940&#8211;1&#46;023&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;373&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;022&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;978&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;884&#8211;1&#46;082&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;665&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DRE abnormality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;859&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;278&#8211;4&#46;361&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;757&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;133&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;912&#8211;4&#46;987&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T stage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;551&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;736&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;030&#8211;2&#46;923&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;038&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;357&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;428&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;691&#8211;2&#46;954&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;336&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Primary biopsy Gleason&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;457&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;633&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;363&#8211;1&#46;105&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;108&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Secondary biopsy Gleason&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;903&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;405&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;241&#8211;0&#46;681&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;375&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;687&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;293&#8211;1&#46;613&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;389&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Biopsy Gleason sum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;759&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;468&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;314&#8211;0&#46;698&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;865&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;421&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;220&#8211;0&#46;804&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sub-cohort &#40;115&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1378538.png"
              ]
            ]
            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="9" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Sub-cohort &#40;115&#41;</th></tr><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Univariate model</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Multivariate model</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">B</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">B</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">B</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pre-operative PSA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;051&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0110&#8211;1&#46;093&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;072&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;015&#8211;1&#46;132&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DRE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;142&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;153&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;462&#8211;2&#46;880&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;761&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T stage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;197&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;218&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;593&#8211;2&#46;500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;591&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Primary biopsy Gleason&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;654&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;240&#8211;1&#46;126&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;097&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Secondary biopsy Gleason&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;1&#46;164&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;312&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;128&#8211;0&#46;764&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;169&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;845&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;222&#8211;3&#46;219&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;805&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Biopsy Gleason sum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;955&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;385&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;202&#8211;0&#46;732&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;1&#46;708&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;181&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;059&#8211;0&#46;577&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Percentage of positive cores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;001&#8211;1&#46;034&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;041&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;024&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;025&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;996&#8211;1&#46;054&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;088&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Positive side&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;078&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;233&#8211;7&#46;011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;773&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;166&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;553&#8211;8&#46;482&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;267&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1378540.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Univariate and multivariate logistic regression models predicting Gleason sum upgrading between biopsy and final pathology&#46;</p>"
        ]
      ]
      4 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc1.pdf"
          "ficheroTamanyo" => 7476
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:29 [
            0 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Classification of prostatic carcinomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;F&#46; Gleason"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Cancer Chemotherapy Rep Part 1"
                        "fecha" => "1966"
                        "volumen" => "50"
                        "paginaInicial" => "125"
                        "paginaFinal" => "128"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The accuracy of diagnostic biopsy specimens in predicting tumor grades by Gleason&#39;s classification of radical prostatectomy specimens"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;E&#46; Garnett"
                            1 => "R&#46; Oyasu"
                            2 => "J&#46;T&#46; Grayhack"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Urol"
                        "fecha" => "1984"
                        "volumen" => "131"
                        "paginaInicial" => "690"
                        "paginaFinal" => "693"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6708183"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gleason grading of prostatic needle biopsies&#46; Correlation with grade in 316 matched prostatectomies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;G&#46; Bostwick"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Surg Pathol"
                        "fecha" => "1994"
                        "volumen" => "18"
                        "paginaInicial" => "796"
                        "paginaFinal" => "803"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8037294"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A nomogram to predict Gleason sum upgrading of clinically diagnosed localized prostate cancer among Chinese patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;Y&#46; Wang"
                            1 => "Y&#46; Zhu"
                            2 => "C&#46;F&#46; Wang"
                            3 => "S&#46;L&#46; Zhang"
                            4 => "B&#46; Dai"
                            5 => "D&#46;W&#46; Ye"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Chinese J Cancer"
                        "fecha" => "2014"
                        "volumen" => "33"
                        "paginaInicial" => "241"
                        "paginaFinal" => "248"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical and pathologic predictors of Gleason sum upgrading in patients after radical prostatectomy&#58; results from a single institution series"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Tilki"
                            1 => "B&#46; Schlenker"
                            2 => "M&#46; John"
                            3 => "A&#46; Buchner"
                            4 => "P&#46; Stanislaus"
                            5 => "C&#46; Gratzke"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.urolonc.2009.07.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Urol Oncol"
                        "fecha" => "2011"
                        "volumen" => "29"
                        "paginaInicial" => "508"
                        "paginaFinal" => "514"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19837614"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development and internal validation of a nomogram predicting the probability of prostate cancer Gleason sum upgrading between biopsy and radical prostatectomy pathology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;K&#46; Chun"
                            1 => "T&#46; Steuber"
                            2 => "A&#46; Erbersdobler"
                            3 => "E&#46; Currlin"
                            4 => "J&#46; Walz"
                            5 => "T&#46; Schlomm"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.eururo.2005.11.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Urol"
                        "fecha" => "2006"
                        "volumen" => "49"
                        "paginaInicial" => "820"
                        "paginaFinal" => "826"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16439050"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The 2005 International Society of Urological Pathology &#40;ISUP&#41; consensus conference on Gleason grading of prostatic carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;I&#46; Epstein"
                            1 => "W&#46;C&#46; Allsbrook Jr&#46;"
                            2 => "M&#46;B&#46; Amin"
                            3 => "L&#46;L&#46; Egevad"
                            4 => "I&#46;G&#46; Committee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Surg Pathol"
                        "fecha" => "2005"
                        "volumen" => "29"
                        "paginaInicial" => "1228"
                        "paginaFinal" => "1242"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16096414"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The American Joint Committee on Cancer&#58; the 7th edition of the AJCC cancer staging manual and the future of TNM"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;B&#46; Edge"
                            1 => "C&#46;C&#46; Compton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1245/s10434-010-0985-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg Oncol"
                        "fecha" => "2010"
                        "volumen" => "17"
                        "paginaInicial" => "1471"
                        "paginaFinal" => "1474"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20180029"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Upgrading and downgrading of prostate cancer from biopsy to radical prostatectomy&#58; incidence and predictive factors using the modified Gleason grading system and factoring in tertiary grades"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;I&#46; Epstein"
                            1 => "Z&#46; Feng"
                            2 => "B&#46;J&#46; Trock"
                            3 => "P&#46;M&#46; Pierorazio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.eururo.2012.01.050"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Urol"
                        "fecha" => "2012"
                        "volumen" => "61"
                        "paginaInicial" => "1019"
                        "paginaFinal" => "1024"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22336380"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Upgrading and downgrading of prostate needle biopsy specimens&#58; risk factors and clinical implications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;J&#46; Freedland"
                            1 => "C&#46;J&#46; Kane"
                            2 => "C&#46;L&#46; Amling"
                            3 => "W&#46;J&#46; Aronson"
                            4 => "M&#46;K&#46; Terris"
                            5 => "J&#46;C&#46; Presti Jr&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.urology.2006.10.036"
                      "Revista" => array:6 [
                        "tituloSerie" => "Urology"
                        "fecha" => "2007"
                        "volumen" => "69"
                        "paginaInicial" => "495"
                        "paginaFinal" => "499"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17382152"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Biopsy core number represents one of foremost predictors of clinically significant gleason sum upgrading in patients with low-risk prostate cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "U&#46; Capitanio"
                            1 => "P&#46;I&#46; Karakiewicz"
                            2 => "L&#46; Valiquette"
                            3 => "P&#46; Perrotte"
                            4 => "C&#46; Jeldres"
                            5 => "A&#46; Briganti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.urology.2008.10.048"
                      "Revista" => array:6 [
                        "tituloSerie" => "Urology"
                        "fecha" => "2009"
                        "volumen" => "73"
                        "paginaInicial" => "1087"
                        "paginaFinal" => "1091"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19195695"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors predicting prostatic biopsy Gleason sum under grading"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;A&#46; Stackhouse"
                            1 => "L&#46; Sun"
                            2 => "F&#46;R&#46; Schroeck"
                            3 => "J&#46; Jayachandran"
                            4 => "A&#46;A&#46; Caire"
                            5 => "C&#46;O&#46; Acholo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.juro.2009.02.127"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Urol"
                        "fecha" => "2009"
                        "volumen" => "182"
                        "paginaInicial" => "118"
                        "paginaFinal" => "122"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19447436"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prostate cancer&#58; new nomogram predicts risk of Gleason upgrading"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Payton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Nature Rev Urol"
                        "fecha" => "2013"
                        "volumen" => "10"
                        "paginaInicial" => "553"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "External validation of a nomogram predicting the probability of prostate cancer Gleason sum upgrading between biopsy and radical prostatectomy pathology among Japanese patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Imamoto"
                            1 => "H&#46; Suzuki"
                            2 => "T&#46; Utsumi"
                            3 => "M&#46; Takano"
                            4 => "T&#46; Suyama"
                            5 => "K&#46; Kawamura"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.urology.2009.05.084"
                      "Revista" => array:6 [
                        "tituloSerie" => "Urology"
                        "fecha" => "2010"
                        "volumen" => "76"
                        "paginaInicial" => "404"
                        "paginaFinal" => "410"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19716590"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development and external validation of a nomogram predicting the probability of significant gleason sum upgrading among Japanese patients with localized prostate cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Imamoto"
                            1 => "T&#46; Utsumi"
                            2 => "M&#46; Takano"
                            3 => "A&#46; Komaru"
                            4 => "S&#46; Fukasawa"
                            5 => "T&#46; Suyama"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1155/2011/754382"
                      "Revista" => array:5 [
                        "tituloSerie" => "Prostate Cancer"
                        "fecha" => "2011"
                        "volumen" => "2011"
                        "paginaInicial" => "754382"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22110999"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of pathological data between prostate biopsy and radical prostatectomy specimen in patients with low to very low risk prostate cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46; Lendinez-Cano"
                            1 => "J&#46; Alonso-Flores"
                            2 => "V&#46; Beltran-Aguilar"
                            3 => "A&#46; Cayuela"
                            4 => "S&#46; Salazar-Otero"
                            5 => "J&#46; Bachiller-Burgos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.acuro.2015.02.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Urol Esp"
                        "fecha" => "2015"
                        "volumen" => "39"
                        "paginaInicial" => "482"
                        "paginaFinal" => "487"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25895440"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Are PSA density and PSA density of the transition zone more accurate than PSA in predicting the pathological stage of clinically localized prostate cancer&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46; Giannarini"
                            1 => "C&#46;A&#46; Scott"
                            2 => "U&#46; Moro"
                            3 => "B&#46; Pertoldi"
                            4 => "C&#46;A&#46; Beltrami"
                            5 => "C&#46; Selli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.urolonc.2007.04.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Urol Oncol"
                        "fecha" => "2008"
                        "volumen" => "26"
                        "paginaInicial" => "353"
                        "paginaFinal" => "360"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18367100"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "PSA in the new millennium&#58; a powerful predictor of prostate cancer prognosis and radical prostatectomy outcomes &#8211; results from the SEARCH database"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;J&#46; Freedland"
                            1 => "J&#46;M&#46; Hotaling"
                            2 => "N&#46;J&#46; Fitzsimons"
                            3 => "J&#46;C&#46; Presti Jr&#46;"
                            4 => "C&#46;J&#46; Kane"
                            5 => "M&#46;K&#46; Terris"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.eururo.2007.08.047"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Urol"
                        "fecha" => "2008"
                        "volumen" => "53"
                        "paginaInicial" => "758"
                        "paginaFinal" => "764"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17868976"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The digital rectal examination &#40;DRE&#41; remains important-outcomes from a contemporary cohort of men undergoing an initial 12-18 core prostate needle biopsy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Palmerola"
                            1 => "P&#46; Smith"
                            2 => "V&#46; Elliot"
                            3 => "C&#46;T&#46; Reese"
                            4 => "F&#46;B&#46; Mahon"
                            5 => "L&#46;E&#46; Harpster"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Canadian J Urol"
                        "fecha" => "2012"
                        "volumen" => "19"
                        "paginaInicial" => "6542"
                        "paginaFinal" => "6547"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cancer statistics&#44; 2016"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;L&#46; Siegel"
                            1 => "K&#46;D&#46; Miller"
                            2 => "A&#46; Jemal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "CA&#58; Cancer J Clin"
                        "fecha" => "2016"
                        "volumen" => "66"
                        "paginaInicial" => "7"
                        "paginaFinal" => "30"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cancer statistics in China&#44; 2015"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46; Chen"
                            1 => "R&#46; Zheng"
                            2 => "P&#46;D&#46; Baade"
                            3 => "S&#46; Zhang"
                            4 => "H&#46; Zeng"
                            5 => "F&#46; Bray"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "CA&#58; Cancer J Clin"
                        "fecha" => "2016"
                        "volumen" => "66"
                        "paginaInicial" => "115"
                        "paginaFinal" => "132"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Active surveillance for prostate cancer&#58; a systematic review of clinicopathologic variables and biomarkers for risk stratification"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Loeb"
                            1 => "S&#46;M&#46; Bruinsma"
                            2 => "J&#46; Nicholson"
                            3 => "A&#46; Briganti"
                            4 => "T&#46; Pickles"
                            5 => "Y&#46; Kakehi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.eururo.2014.10.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Urol"
                        "fecha" => "2015"
                        "volumen" => "67"
                        "paginaInicial" => "619"
                        "paginaFinal" => "626"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25457014"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Active surveillance for clinically localized prostate cancer &#8211; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "F&#46;B&#46; Thomsen"
                            1 => "K&#46; Brasso"
                            2 => "L&#46;H&#46; Klotz"
                            3 => "M&#46;A&#46; Roder"
                            4 => "K&#46;D&#46; Berg"
                            5 => "P&#46; Iversen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jso.23584"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Surg Oncol"
                        "fecha" => "2014"
                        "volumen" => "109"
                        "paginaInicial" => "830"
                        "paginaFinal" => "835"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24610744"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multifocal prostate cancer&#58; biologic&#44; prognostic&#44; and therapeutic implications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Andreoiu"
                            1 => "L&#46; Cheng"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Human Pathol"
                        "fecha" => "2010"
                        "volumen" => "41"
                        "paginaInicial" => "781"
                        "paginaFinal" => "793"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Optimal approach for prostate cancer detection as initial biopsy&#58; prospective randomized study comparing transperineal versus transrectal systematic 12-core biopsy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Hara"
                            1 => "Y&#46; Jo"
                            2 => "T&#46; Fujii"
                            3 => "N&#46; Kondo"
                            4 => "T&#46; Yokoyoma"
                            5 => "Y&#46; Miyaji"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.urology.2007.09.029"
                      "Revista" => array:6 [
                        "tituloSerie" => "Urology"
                        "fecha" => "2008"
                        "volumen" => "71"
                        "paginaInicial" => "191"
                        "paginaFinal" => "195"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18308081"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of image-guided targeted biopsies versus systematic randomized biopsies in the detection of prostate cancer&#58; a systematic literature review of well-designed studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; van Hove"
                            1 => "P&#46;H&#46; Savoie"
                            2 => "C&#46; Maurin"
                            3 => "S&#46; Brunelle"
                            4 => "G&#46; Gravis"
                            5 => "N&#46; Salem"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00345-014-1332-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Urol"
                        "fecha" => "2014"
                        "volumen" => "32"
                        "paginaInicial" => "847"
                        "paginaFinal" => "858"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24919965"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of MR&#47;ultrasound fusion-guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;M&#46; Siddiqui"
                            1 => "S&#46; Rais-Bahrami"
                            2 => "B&#46; Turkbey"
                            3 => "A&#46;K&#46; George"
                            4 => "J&#46; Rothwax"
                            5 => "N&#46; Shakir"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2014.17942"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2015"
                        "volumen" => "313"
                        "paginaInicial" => "390"
                        "paginaFinal" => "397"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25626035"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Magnetic resonance and ultrasound image fusion supported transperineal prostate biopsy using the ginsburg protocol&#58; technique&#44; learning points&#44; and biopsy results"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Hansen"
                            1 => "G&#46; Patruno"
                            2 => "K&#46; Wadhwa"
                            3 => "G&#46; Gaziev"
                            4 => "R&#46; Miano"
                            5 => "T&#46; Barrett"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Eur Urol"
                        "fecha" => "2016"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The 2014 International Society of Urological Pathology &#40;ISUP&#41; Consensus Conference on Gleason grading of prostatic carcinoma&#58; definition of grading patterns and proposal for a new grading system"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;I&#46; Epstein"
                            1 => "L&#46; Egevad"
                            2 => "M&#46;B&#46; Amin"
                            3 => "B&#46; Delahunt"
                            4 => "J&#46;R&#46; Srigley"
                            5 => "P&#46;A&#46; Humphrey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Sur Pathol"
                        "fecha" => "2016"
                        "volumen" => "40"
                        "paginaInicial" => "244"
                        "paginaFinal" => "252"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735786/0000004100000003/v1_201703250114/S2173578617300124/v1_201703250114/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6274"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735786/0000004100000003/v1_201703250114/S2173578617300124/v1_201703250114/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578617300124?idApp=UINPBA00004N"
]