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Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy
The positive surgical margin (PSM) and biochemical recurrence (BCR) are two main factors associated with poor oncotherapeutic outcomes after prostatectomy. This is an Asian population study based on a single-surgeon experience to deeply investigate the predictors for PSM and BCR. We retrospectively...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275750/ https://www.ncbi.nlm.nih.gov/pubmed/34253832 http://dx.doi.org/10.1038/s41598-021-93860-y |
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author | Yang, Ching-Wei Wang, Hsiao-Hsien Hassouna, Mohamed Fayez Chand, Manish Huang, William J. S. Chung, Hsiao-Jen |
author_facet | Yang, Ching-Wei Wang, Hsiao-Hsien Hassouna, Mohamed Fayez Chand, Manish Huang, William J. S. Chung, Hsiao-Jen |
author_sort | Yang, Ching-Wei |
collection | PubMed |
description | The positive surgical margin (PSM) and biochemical recurrence (BCR) are two main factors associated with poor oncotherapeutic outcomes after prostatectomy. This is an Asian population study based on a single-surgeon experience to deeply investigate the predictors for PSM and BCR. We retrospectively included 419 robot-assisted radical prostatectomy cases. The number of PSM cases was 126 (30.1%), stratified as 22 (12.2%) in stage T2 and 103 (43.6%) in stage T3. Preoperative prostate-specific antigen (PSA) > 10 ng/mL (p = 0.047; odds ratio [OR] 1.712), intraoperative blood loss > 200 mL (p = 0.006; OR 4.01), and postoperative pT3 stage (p < 0.001; OR 6.901) were three independent predictors for PSM while PSA > 10 ng/mL (p < 0.015; hazard ratio [HR] 1.8), pT3 stage (p = 0.012; HR 2.264), International Society of Urological Pathology (ISUP) grade > 3 (p = 0.02; HR 1.964), and PSM (p = 0.027; HR 1.725) were four significant predictors for BCR in multivariable analysis. PSMs occurred mostly in the posterolateral regions (73.8%) which were associated with nerve-sparing procedures (p = 0.012) while apical PSMs were correlated intraoperative bleeding (p < 0.001). A high ratio of pT3 stage after RARP in our Asian population-based might surpass the influence of PSM on BCR. PSM was less significant than PSA and ISUP grade for predicting PSA recurrence in pT3 disease. Among PSM cases, unifocal and multifocal positive margins had a similar ratio of the BCR rate (p = 0.172) but ISUP grade > 3 (p = 0.002; HR 2.689) was a significant BCR predictor. These results indicate that PSA and pathological status are key factors influencing PSM and BCR. |
format | Online Article Text |
id | pubmed-8275750 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-82757502021-07-13 Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy Yang, Ching-Wei Wang, Hsiao-Hsien Hassouna, Mohamed Fayez Chand, Manish Huang, William J. S. Chung, Hsiao-Jen Sci Rep Article The positive surgical margin (PSM) and biochemical recurrence (BCR) are two main factors associated with poor oncotherapeutic outcomes after prostatectomy. This is an Asian population study based on a single-surgeon experience to deeply investigate the predictors for PSM and BCR. We retrospectively included 419 robot-assisted radical prostatectomy cases. The number of PSM cases was 126 (30.1%), stratified as 22 (12.2%) in stage T2 and 103 (43.6%) in stage T3. Preoperative prostate-specific antigen (PSA) > 10 ng/mL (p = 0.047; odds ratio [OR] 1.712), intraoperative blood loss > 200 mL (p = 0.006; OR 4.01), and postoperative pT3 stage (p < 0.001; OR 6.901) were three independent predictors for PSM while PSA > 10 ng/mL (p < 0.015; hazard ratio [HR] 1.8), pT3 stage (p = 0.012; HR 2.264), International Society of Urological Pathology (ISUP) grade > 3 (p = 0.02; HR 1.964), and PSM (p = 0.027; HR 1.725) were four significant predictors for BCR in multivariable analysis. PSMs occurred mostly in the posterolateral regions (73.8%) which were associated with nerve-sparing procedures (p = 0.012) while apical PSMs were correlated intraoperative bleeding (p < 0.001). A high ratio of pT3 stage after RARP in our Asian population-based might surpass the influence of PSM on BCR. PSM was less significant than PSA and ISUP grade for predicting PSA recurrence in pT3 disease. Among PSM cases, unifocal and multifocal positive margins had a similar ratio of the BCR rate (p = 0.172) but ISUP grade > 3 (p = 0.002; HR 2.689) was a significant BCR predictor. These results indicate that PSA and pathological status are key factors influencing PSM and BCR. Nature Publishing Group UK 2021-07-12 /pmc/articles/PMC8275750/ /pubmed/34253832 http://dx.doi.org/10.1038/s41598-021-93860-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Yang, Ching-Wei Wang, Hsiao-Hsien Hassouna, Mohamed Fayez Chand, Manish Huang, William J. S. Chung, Hsiao-Jen Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy |
title | Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy |
title_full | Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy |
title_fullStr | Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy |
title_full_unstemmed | Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy |
title_short | Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy |
title_sort | prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275750/ https://www.ncbi.nlm.nih.gov/pubmed/34253832 http://dx.doi.org/10.1038/s41598-021-93860-y |
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