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Predictors of Prolonged Laparoscopic Radical Prostatectomy and the Creation of a Scoring System for the Duration

PURPOSE: To identify the relevant factors, and create and validate a predictive scoring system for the duration of laparoscopic radical prostatectomy (LRP). PATIENTS AND METHODS: We retrospectively analyzed clinicopathological data from 436 patients who underwent LRP between January 2014 and January...

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Autores principales: Chen, Shao-Hao, Ke, Zhi-Bin, Wu, Yu-Peng, Chen, Dong-Ning, Yu, Xiang, Chen, Yu, Wei, Yong, Zheng, Qing-Shui, Xue, Xue-Yi, Xu, Ning
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7481309/
https://www.ncbi.nlm.nih.gov/pubmed/32943933
http://dx.doi.org/10.2147/CMAR.S265480
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author Chen, Shao-Hao
Ke, Zhi-Bin
Wu, Yu-Peng
Chen, Dong-Ning
Yu, Xiang
Chen, Yu
Wei, Yong
Zheng, Qing-Shui
Xue, Xue-Yi
Xu, Ning
author_facet Chen, Shao-Hao
Ke, Zhi-Bin
Wu, Yu-Peng
Chen, Dong-Ning
Yu, Xiang
Chen, Yu
Wei, Yong
Zheng, Qing-Shui
Xue, Xue-Yi
Xu, Ning
author_sort Chen, Shao-Hao
collection PubMed
description PURPOSE: To identify the relevant factors, and create and validate a predictive scoring system for the duration of laparoscopic radical prostatectomy (LRP). PATIENTS AND METHODS: We retrospectively analyzed clinicopathological data from 436 patients who underwent LRP between January 2014 and January 2019, of whom 304 cases were used as a model creation group and 132 were used as a validation group. Uni/multivariate linear regression analysis was performed to determine the predictors of the duration of the procedure and a novel scoring system was created using these predictors. External validation of the scoring system was performed. The Hosmer–Lemeshow test was used to determine the goodness-of-fit of the model and calibration plots were created for visual assessment. RESULTS: “Prolonged duration” was defined as a duration of the procedure that was longer than the mean (>150 min) duration. Multivariate analysis showed that body mass index (BMI), prostate volume, intravesicular protrusion of the prostate (IPP), the ratio of the cross-sectional areas of the prostate and the Retzius space (P/R), pelvic lymph node dissection, and neurovascular bundle (NVB) preservation were significant predictors of prolonged duration. A scoring system that included these six parameters was created and the area under the curve achieved during receiver operating characteristic analysis using this scoring system was 0.874 (95% confidence interval [CI]: 0.836–0.913). The Hosmer–Lemeshow test showed that the scoring system was well calibrated (X(2)=5.339, P=0.376). The external validation showed that the model had high predictive accuracy (AUC=0.835, 95% CI: 0.764–0.906) and goodness-of-fit (X(2)=4.401, P=0.493). CONCLUSION: The following factors were significantly associated with prolonged duration of laparoscopic radical prostatectomy: BMI, prostate volume, IPP, P/R, pelvic lymph node dissection, and NVB preservation. The novel scoring system created can be used to accurately predict the duration of the procedure, assess the difficulty of surgery, and improve perioperative efficiency.
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spelling pubmed-74813092020-09-16 Predictors of Prolonged Laparoscopic Radical Prostatectomy and the Creation of a Scoring System for the Duration Chen, Shao-Hao Ke, Zhi-Bin Wu, Yu-Peng Chen, Dong-Ning Yu, Xiang Chen, Yu Wei, Yong Zheng, Qing-Shui Xue, Xue-Yi Xu, Ning Cancer Manag Res Original Research PURPOSE: To identify the relevant factors, and create and validate a predictive scoring system for the duration of laparoscopic radical prostatectomy (LRP). PATIENTS AND METHODS: We retrospectively analyzed clinicopathological data from 436 patients who underwent LRP between January 2014 and January 2019, of whom 304 cases were used as a model creation group and 132 were used as a validation group. Uni/multivariate linear regression analysis was performed to determine the predictors of the duration of the procedure and a novel scoring system was created using these predictors. External validation of the scoring system was performed. The Hosmer–Lemeshow test was used to determine the goodness-of-fit of the model and calibration plots were created for visual assessment. RESULTS: “Prolonged duration” was defined as a duration of the procedure that was longer than the mean (>150 min) duration. Multivariate analysis showed that body mass index (BMI), prostate volume, intravesicular protrusion of the prostate (IPP), the ratio of the cross-sectional areas of the prostate and the Retzius space (P/R), pelvic lymph node dissection, and neurovascular bundle (NVB) preservation were significant predictors of prolonged duration. A scoring system that included these six parameters was created and the area under the curve achieved during receiver operating characteristic analysis using this scoring system was 0.874 (95% confidence interval [CI]: 0.836–0.913). The Hosmer–Lemeshow test showed that the scoring system was well calibrated (X(2)=5.339, P=0.376). The external validation showed that the model had high predictive accuracy (AUC=0.835, 95% CI: 0.764–0.906) and goodness-of-fit (X(2)=4.401, P=0.493). CONCLUSION: The following factors were significantly associated with prolonged duration of laparoscopic radical prostatectomy: BMI, prostate volume, IPP, P/R, pelvic lymph node dissection, and NVB preservation. The novel scoring system created can be used to accurately predict the duration of the procedure, assess the difficulty of surgery, and improve perioperative efficiency. Dove 2020-09-04 /pmc/articles/PMC7481309/ /pubmed/32943933 http://dx.doi.org/10.2147/CMAR.S265480 Text en © 2020 Chen et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Chen, Shao-Hao
Ke, Zhi-Bin
Wu, Yu-Peng
Chen, Dong-Ning
Yu, Xiang
Chen, Yu
Wei, Yong
Zheng, Qing-Shui
Xue, Xue-Yi
Xu, Ning
Predictors of Prolonged Laparoscopic Radical Prostatectomy and the Creation of a Scoring System for the Duration
title Predictors of Prolonged Laparoscopic Radical Prostatectomy and the Creation of a Scoring System for the Duration
title_full Predictors of Prolonged Laparoscopic Radical Prostatectomy and the Creation of a Scoring System for the Duration
title_fullStr Predictors of Prolonged Laparoscopic Radical Prostatectomy and the Creation of a Scoring System for the Duration
title_full_unstemmed Predictors of Prolonged Laparoscopic Radical Prostatectomy and the Creation of a Scoring System for the Duration
title_short Predictors of Prolonged Laparoscopic Radical Prostatectomy and the Creation of a Scoring System for the Duration
title_sort predictors of prolonged laparoscopic radical prostatectomy and the creation of a scoring system for the duration
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7481309/
https://www.ncbi.nlm.nih.gov/pubmed/32943933
http://dx.doi.org/10.2147/CMAR.S265480
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