Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy

Abstract 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 retrosp...

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Autores principales:	Ching-Wei Yang, Hsiao-Hsien Wang, Mohamed Fayez Hassouna, Manish Chand, William J. S. Huang, Hsiao-Jen Chung
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9a8f58c550ad46ac8b025d1839ff396f
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spelling	oai:doaj.org-article:9a8f58c550ad46ac8b025d1839ff396f2021-12-02T15:33:01ZPrediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy10.1038/s41598-021-93860-y2045-2322https://doaj.org/article/9a8f58c550ad46ac8b025d1839ff396f2021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93860-yhttps://doaj.org/toc/2045-2322Abstract 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.Ching-Wei YangHsiao-Hsien WangMohamed Fayez HassounaManish ChandWilliam J. S. HuangHsiao-Jen ChungNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ching-Wei Yang Hsiao-Hsien Wang Mohamed Fayez Hassouna Manish Chand William J. S. Huang Hsiao-Jen Chung Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy
description	Abstract 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	article
author	Ching-Wei Yang Hsiao-Hsien Wang Mohamed Fayez Hassouna Manish Chand William J. S. Huang Hsiao-Jen Chung
author_facet	Ching-Wei Yang Hsiao-Hsien Wang Mohamed Fayez Hassouna Manish Chand William J. S. Huang Hsiao-Jen Chung
author_sort	Ching-Wei Yang
title	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_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_sort	prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/9a8f58c550ad46ac8b025d1839ff396f
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Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy

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