|Table of Contents|

Establishment and application of a positive columnar map of the margin after laparoscopic radical prostatectomy

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 09
Page:
1682-1689
Research Field:
Publishing date:

Info

Title:
Establishment and application of a positive columnar map of the margin after laparoscopic radical prostatectomy
Author(s):
GUO Sheng1; 2; YANG Jin1; MIAO Guoliang1; ZHOU Fenghai2
1.First Clinical College of Medicine,Gansu University of Traditional Chinese Medicine,Gansu Lanzhou 730000,China;2.Department of Urology,Gansu Provincial People's Hospital,Gansu Lanzhou 730050,China.
Keywords:
prostate cancer; positive surgical margin; early urinary control recovery; column line graph; model analysis
PACS:
R737.25
DOI:
10.3969/j.issn.1672-4992.2024.09.019
Abstract:
Objective:To construct a nomogram model to predict positive margins after laparoscopic radical prostatectomy and to explore preoperative predictors of early urinary control recovery.Methods:We included 153 patients who underwent laparoscopic radical prostatectomy via the extraperitoneal route,of whom 47 had positive postoperative margins and 106 had negative postoperative margins.We screened the independent risk factors for the occurrence of positive postoperative margins using univariate and multifactorial Logistic regression analyses,and constructed a columnar graphical prediction model incorporating these factors.We used a receiver operating characteristic (ROC) curve to assess the prediction model's,the efficacy of predicting positive postoperative margins was evaluated with calibration curves to assess the accuracy of prediction,and the clinical benefit was compared with decision curve analysis (DCA).Patients were followed up for 3 months postoperatively for recovery of urinary control,and preoperative imaging factors for recovery of urinary control after laparoscopic radical prostatectomy were analyzed by Cox regression.Results:Serum prostate-specific antigen (PSA),perineural invasion,clinical T-stage,and postoperative pathological T-stage were the clinically independent risk factors for a positive postoperative margin and were combined to construct a column-line diagram model.The area under the ROC curve was 0.896 (95%CI:0.798~0.918) indicating a high predictive accuracy of the model.The calibration curve was close to the ideal curve,and the model calibration ability was good.DCA showed that the column-line diagram model had good clinical benefit.Univariate Cox regression analysis showed that prostate volume,transurethral electrolysis of the prostate,perineural invasion of the perineurium,Gleason score of perineurial pathology,number of positive perineurial needles,percentage of positive perineurial needles,and clinical T stage were correlated with the recovery of urinary control,multifactorial Cox regression analysis showed that prostate volume (HR=0.721,95%CI:1.024~1.132) and transurethral electrolysis of the prostate (HR=0.691,95%CI:0.503~0.891) were independent risk factors for postoperative urinary control recovery recovery after laparoscopic radical prostatectomy.Conclusion:A prediction model for the risk of developing positive margins after radical prostatectomy in patients with prostate cancer was successfully constructed.The model efficacy is good,and it is potentially useful for individualized prediction of the development of positive margins after radical prostatectomy.Prostate volume and transurethral electrolysis of the prostate are independent risk factors for urological control recovery.

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Memo

Memo:
甘肃省重点研发计划资助项目（编号：21YF5FA016）
Last Update: 2024-03-29