Development of preoperative nomograms to predict the risk of overall and multifocal positive surgical margin after radical prostatectomy.
Cancer Imaging
; 24(1): 104, 2024 Aug 08.
Article
in En
| MEDLINE
| ID: mdl-39118144
ABSTRACT
OBJECTIVE:
To develop preoperative nomograms using risk factors based on clinicopathological and MRI for predicting the risk of positive surgical margin (PSM) after radical prostatectomy (RP). PATIENTS ANDMETHODS:
This study retrospectively enrolled patients who underwent prostate MRI before RP at our center between January 2015 and November 2022. Preoperative clinicopathological factors and MRI-based features were recorded for analysis. The presence of PSM (overall PSM [oPSM]) at pathology and the multifocality of PSM (mPSM) were evaluated. LASSO regression was employed for variable selection. For the final model construction, logistic regression was applied combined with the bootstrap method for internal verification. The risk probability of individual patients was visualized using a nomogram.RESULTS:
In all, 259 patients were included in this study, and 76 (29.3%) patients had PSM, including 40 patients with mPSM. Final multivariate logistic regression revealed that the independent risk factors for oPSM were tumor diameter, frank extraprostatic extension, and annual surgery volume (all p < 0.05), and the nomogram for oPSM reached an area under the curve (AUC) of 0.717 in development and 0.716 in internal verification. The independent risk factors for mPSM included the percentage of positive cores, tumor diameter, apex depth, and annual surgery volume (all p < 0.05), and the AUC of the nomogram for mPSM was 0.790 in both development and internal verification. The calibration curve analysis showed that these nomograms were well-calibrated for both oPSM and mPSM.CONCLUSIONS:
The proposed nomograms showed good performance and were feasible in predicting oPSM and mPSM, which might facilitate more individualized management of prostate cancer patients who are candidates for surgery.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prostatectomy
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Prostatic Neoplasms
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Magnetic Resonance Imaging
/
Nomograms
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Margins of Excision
Limits:
Aged
/
Humans
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Male
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Middle aged
Language:
En
Journal:
Cancer Imaging
Journal subject:
DIAGNOSTICO POR IMAGEM
/
NEOPLASIAS
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: