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Feng T, Liang Z, Xiao Y, Pan B, Zhou Y, Ma C, Zhou Z, Yan W, Zhu M. Can a nomogram predict apical prostate cancer pathology upgrade from fusion biopsy to final pathology? A multicenter study. Cancer Med 2024; 13:e7341. [PMID: 38845479 PMCID: PMC11157165 DOI: 10.1002/cam4.7341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 04/05/2024] [Accepted: 05/12/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND This study evaluates the efficacy of a nomogram for predicting the pathology upgrade of apical prostate cancer (PCa). METHODS A total of 754 eligible patients were diagnosed with apical PCa through combined systematic and magnetic resonance imaging (MRI)-targeted prostate biopsy followed by radical prostatectomy (RP) were retrospectively identified from two hospitals (training: 754, internal validation: 182, internal-external validation: 148). A nomogram for the identification of apical tumors in high-risk pathology upgrades through comparing the results of biopsy and RP was established incorporating statistically significant risk factors based on univariable and multivariable logistic regression. The nomogram's performance was assessed via the receiver operating characteristic (ROC) curve, calibration plots, and decision curve analysis (DCA). RESULTS Univariable and multivariable analysis identified age, targeted biopsy, number of targeted cores, TNM stage, and the prostate imaging-reporting and data system score as significant predictors of apical tumor pathological progression. Our nomogram, based on these variables, demonstrated ROC curves for pathology upgrade with values of 0.883 (95% CI, 0.847-0.929), 0.865 (95% CI, 0.790-0.945), and 0.840 (95% CI, 0.742-0.904) for the training, internal validation and internal-external validation cohorts respectively. Calibration curves showed good consistency between the predicted and actual outcomes. The validation groups also showed great generalizability with the calibration curves. DCA results also demonstrated excellent performance for our nomogram with positive benefit across a threshold probability range of 0-0.9 for the training and internal validation group, and 0-0.6 for the internal-external validation group. CONCLUSION The nomogram, integrating clinical, radiological, and pathological data, effectively predicts the risk of pathology upgrade in apical PCa tumors. It holds significant potential to guide clinicians in optimizing the surgical management of these patients.
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Affiliation(s)
- Tianrui Feng
- Department of UrologyPeking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical SciencesBeijingChina
| | - Zhen Liang
- Department of UrologyPeking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical SciencesBeijingChina
| | - Yu Xiao
- Department of PathologyPeking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical SciencesBeijingChina
| | - Boju Pan
- Department of PathologyPeking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical SciencesBeijingChina
| | - Yi Zhou
- Department of UrologyPeking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical SciencesBeijingChina
| | - Chengquan Ma
- Department of UrologyTianjin Medical University General HospitalTianjinChina
| | - Zhien Zhou
- Department of UrologyPeking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical SciencesBeijingChina
| | - Weigang Yan
- Department of UrologyPeking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical SciencesBeijingChina
| | - Ming Zhu
- Department of UrologyPeking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical SciencesBeijingChina
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Hatayama T, Goto K, Fujiyama K, Goriki A, Kaneko M, Mita K. Risk classification system using the detailed positive surgical margin status for predicting biochemical recurrence after robot-assisted radical prostatectomy. Asia Pac J Clin Oncol 2024. [PMID: 38512888 DOI: 10.1111/ajco.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 09/01/2023] [Accepted: 02/25/2024] [Indexed: 03/23/2024]
Abstract
AIM This study aimed to evaluate the risk classification system using the detailed positive surgical margin (PSM) status to predict biochemical recurrence (BCR) after robot-assisted radical prostatectomy (RARP). METHODS We retrospectively analyzed 427 patients who underwent RARP between January 2016 and March 2020. We investigated risk factors for BCR using univariate and multivariate Cox proportional hazard regression models. The biochemical recurrence-free survival (BRFS) rate was assessed using the Kaplan-Meier method. RESULTS The median follow-up period was 43.4 months and 99 patients developed BCR. In the multivariate analysis, maximum PSM length > 5.0 mm and the International Society of Urological Pathology grade group (ISUP GG) at the PSM ≥3 were predictive factors for BCR in patients with a PSM. In the multivariate analysis, these factors were also independent predictive factors in the overall study population, including patients without a PSM. We classified the patients into four groups using these factors and found that the 1-year BRFS rates in the negative surgical margin (NSM) group, low-risk group (PSM and neither factor), intermediate-risk group (either factor), and high-risk group (both factors) were 94.9%, 94.5%, 83.1%, and 52.9%, respectively. The low-risk group showed similar BRFS to the NSM group (p = 0.985), while the high-risk group had significantly worse BRFS than the other groups (p < 0.001). CONCLUSION Maximum PSM length > 5.0 mm and ISUP GG at the PSM ≥3 were independent predictive factors for BCR after RARP. Risk classification for BCR using these factors is considered to be useful and might help urologists decide on additional treatment after RARP.
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Affiliation(s)
- Tomoya Hatayama
- Department of Urology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
| | - Keisuke Goto
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kenta Fujiyama
- Department of Urology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
| | - Akihiro Goriki
- Department of Urology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
| | - Mayumi Kaneko
- Department of Diagnostic Pathology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
| | - Koji Mita
- Department of Urology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
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John A, Lim A, Catterwell R, Selth L, O'Callaghan M. Length of positive surgical margins after radical prostatectomy: Does size matter? - A systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2023; 26:673-680. [PMID: 36859711 PMCID: PMC10638086 DOI: 10.1038/s41391-023-00654-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 01/19/2023] [Accepted: 01/31/2023] [Indexed: 03/03/2023]
Abstract
OBJECTIVES The prognostic capacity of positive surgical margins (PSM) for biochemical recurrence (BCR) is unclear, with inconsistent findings across published studies. We aimed to systematically review and perform a meta-analysis exploring the impact of Positive surgical margin length on biochemical recurrence in men after radical prostatectomy. METHODS A search was conducted using the MEDLINE, Scopus, Embase and Cochrane databases according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The quality of the studies was assessed using the Newcastle-Ottawa scale, and the protocol was registered in advance (PROSPERO: CRD42020195908). This meta-analysis included 16 studies with BCR as the primary outcome measure. RESULTS Studies used various dichotomised thresholds for PSM length. A subgroup meta-analysis was performed using the reported multivariable hazard ratio (Continuous, 3, and 1 mm PSM length). PSM length (continuous) was independently associated with an increased risk of BCR (7 studies, HR 1.04 (CI 1.02-1.05), I2 = 8% p < 0.05). PSM length greater than 3 mm conferred a higher risk of BCR compared to less than 3 mm (4 studies, HR 1.99 (1.54-2.58) I2 = 0%, p < 0.05). There was also an increased risk of BCR associated with PSM length of less than 1 mm compared to negative surgical margins (3 studies, HR 1.46 (1.05-2.04), I2 = 0%, P = 0.02). CONCLUSION PSM length is independently prognostic for BCR after radical prostatectomy. Further long-term studies are needed to estimate the impact on systemic progression.
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Affiliation(s)
- Athul John
- Adelaide Medical School, The University of Adelaide Faculty of Health and Medical, Sciences, Adelaide, South Australia, Australia.
- Urology, Central Adelaide Local Health Network, Adelaide, South Australia, Australia.
| | - Alicia Lim
- Adelaide Medical School, The University of Adelaide Faculty of Health and Medical, Sciences, Adelaide, South Australia, Australia
- Urology, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Rick Catterwell
- Adelaide Medical School, The University of Adelaide Faculty of Health and Medical, Sciences, Adelaide, South Australia, Australia
- Urology, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Luke Selth
- Adelaide Medical School, The University of Adelaide Faculty of Health and Medical, Sciences, Adelaide, South Australia, Australia
- Flinders Health and Medical Research Institute (FHMRI) and Freemasons Centre for Male Health and Wellbeing, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Michael O'Callaghan
- Adelaide Medical School, The University of Adelaide Faculty of Health and Medical, Sciences, Adelaide, South Australia, Australia
- Flinders Health and Medical Research Institute (FHMRI) and Freemasons Centre for Male Health and Wellbeing, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Urology, Southern Adelaide Local Health Network, South Australia Prostate Cancer Clinical Outcomes Collaborative, Adelaide, South Australia, Australia
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Papa N, Perera M, Bensley JG, Evans M, Millar J, Frydenberg M, Murphy DG, Bolton D. A decade of declining prostatectomy margin positivity within a prostate cancer clinical quality registry. Urol Oncol 2022; 40:537.e19-537.e24. [PMID: 36167774 DOI: 10.1016/j.urolonc.2022.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/28/2022] [Indexed: 01/13/2023]
Abstract
CONTEXT Positive surgical margin (PSM) on radical prostatectomy (RP) is associated with an increased risk of biochemical recurrence and use of salvage therapies. Given these adverse consequences, exploration of time trends and predictors of PSM will improve the patient outcomes following surgery for prostate cancer. METHODS Pathological data from RP patients treated from 2011 to 2020 was extracted from the Victorian Prostate Cancer Outcomes Registry. This is a clinical quality registry that regularly benchmarks and reports back to individual clinicians the PSM percentage for their patients. Trends in PSM over time were visualized with separate running mean plots for both pT2 and pT3/4 disease. Predictors of PSM were explored with multivariable regression with date of surgery, surgical method, and hospital type, public or private, entered as covariates. RESULTS In total, 12,394 patients formed the sample with PSM recorded in 25% (n = 3,141) of patients, 12% (777/6,640) in pT2 disease and 41% (2,364/5,754) in pT3/4 disease. Comparing 2011-12 to 2019-20, the pT3/4 PSM proportion declined from 50% to 38% while pT2 percentages were steady at 13%. In "high volume" institutions, pT2 PSM fell from 12% to 6.5%. Independent predictors of lower PSM were robotic vs. open method and being treated at a private vs. public institution. CONCLUSION A clear decline in the proportion of pT3 PSM was observed in a large prostate cancer registry. Proposed explanatory factors include improved technical proficiency with robotic surgery and participation in a registry-based quality improvement initiative.
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Affiliation(s)
- Nathan Papa
- School of Public Health and Preventive Medicine, Monash University, Australia.
| | - Marlon Perera
- Department of Surgery, Austin Health, University of Melbourne, Australia; Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jonathan G Bensley
- School of Public Health and Preventive Medicine, Monash University, Australia
| | - Melanie Evans
- School of Public Health and Preventive Medicine, Monash University, Australia
| | - Jeremy Millar
- School of Public Health and Preventive Medicine, Monash University, Australia; Radiation Oncology, Alfred Health, Melbourne, Victoria, Australia
| | - Mark Frydenberg
- Department of Surgery, Monash University, Australia; Prostate Cancer Research Program, Faculty of Nursing, Medicine & Health Sciences, Monash University, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia
| | - Damien Bolton
- Department of Surgery, Austin Health, University of Melbourne, Australia
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Kupski T, Małek M, Mor I. The association of a risk group with positive margin in the intraoperative and final pathology examination after robotic radical prostatectomy. Cent European J Urol 2022; 74:491-495. [PMID: 35083067 PMCID: PMC8771131 DOI: 10.5173/ceju.2021.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/06/2021] [Accepted: 07/10/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction The aim of this study was to evaluate the risk of a positive margin in the intraoperative and final pathology depending on the risk group for biochemical recurrence in biopsy specimens after robot-assisted radical prostatectomy (RaRP) with sparing of the neurovascular bundles (NS). Material and methods The study was prospective and non-randomised. The intraoperative and final pathology examinations were performed in 65 consecutive patients treated with RaRP between 11.2019–08.2020. In the intraoperative examination, the site of the dissected neurovascular bundles and any suspicious places were examined. Patients were divided into 3 risk groups [according to the European Association of Urology (EAU) biochemical recurrence-risk stratification]. Due to the uncertain prognostic value of microscopic positive margins, 3 groups were identified: R0, Rmicro and R1. Results In the intraoperative examination, the distribution of risk groups in R0, Rmicro and R1 groups is similar (p = 0.132). In the postoperative study, the distribution of risk groups in each margin group is different, and is statistically significant (p <0.001). It has been shown that an increase in the risk group is an indicator of the occurrence of a positive margin in the final histopathological result regardless of the inclusion of Rmicro into R1 or into R0 by 2.68 and 6.52 times, respectively. Conclusions The preoperative risk group is an important factor for the occurrence of a positive margin, but only in the final examination and not in the intraoperative one. An intraoperative examination of the neurovascular bundles only is pointless and should be extended to the examination of the apex.
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Affiliation(s)
- Tomasz Kupski
- Mazovia Hospital Warsaw, Department of Urology, Warsaw, Poland
| | - Michał Małek
- Mazovia Hospital Warsaw, Department of Urology, Warsaw, Poland
| | - Igal Mor
- Mazovia Hospital Warsaw, Department of Urology, Warsaw, Poland
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Berrens AC, van Leeuwen PJ, Maurer T, Hadaschik BA, Krafft U. Implementation of radioguided surgery in prostate cancer. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2021; 65:202-214. [PMID: 34105337 DOI: 10.23736/s1824-4785.21.03348-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
With the development of new imaging technologies and tracers, the applications of radioguided surgery for prostate cancer are growing rapidly. The current paper aims to give an overview of the recent advances of radioguided surgery in the management of prostate cancer. We performed a literature search to give an overview of the current status of radioguided surgery for prostate cancer. Three modalities of radioguided surgery, the sentinel node procedure, Cerenkov Luminescence / beta-radio-guided surgery and radio-guided salvage surgery in recurrent prostate cancer, were reviewed in detail. Radioguided surgery for prostate cancer has shown promising value in the treatment of primary diagnosed prostate cancer and recurrent loco-regional lymph node positive prostate cancer. Advances have been made into minimal invasive (robot-assisted) laparoscopic surgery. The sentinel node procedure for prostate cancer has been further developed and is currently performed with high diagnostic sensitivity. Cerenkov luminescence imaging is a feasible and encouraging technique for intraoperative margin assessment in prostate cancer. Radioguided surgery in recurrent prostate cancer has shown to be feasible, yielding high sensitivity and specificity for detecting small local recurrences and metastases. With the availability of different new tracers, the road has been paved towards clinically feasible radioguided surgery for prostate cancer. Novel technologies now being developed for minimal invasive surgery are speeding up clinical research. Currently, none of the radioguided surgery techniques mentioned have been accepted as standard of care.
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Affiliation(s)
- Anne-Claire Berrens
- Department of Urology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Pim J van Leeuwen
- Department of Urology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Tobias Maurer
- Department of Urology, Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Boris A Hadaschik
- Department of Urology, West German Cancer Center, Essen University Hospital, Essen, Germany
| | - Ulrich Krafft
- Department of Urology, West German Cancer Center, Essen University Hospital, Essen, Germany -
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Lian Z, Zhang H, He Z, Ma S, Wang X, Liu R. Impact of positive surgical margin location and perineural invasion on biochemical recurrence in patients undergoing radical prostatectomy. World J Surg Oncol 2020; 18:201. [PMID: 32791998 PMCID: PMC7427290 DOI: 10.1186/s12957-020-01977-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/30/2020] [Indexed: 01/16/2023] Open
Abstract
Objective To estimate the prognostic value of positive surgical margins (PSM) location and perineural invasion (PNI) for biochemical recurrence (BCR) in patients undergoing radical prostatectomy (RP). Methods All men with prostate cancer (PCa) who received RP in the second hospital of Tianjin Medical University from 2014 to 2018 were retrospectively identified. All patients met the following criteria: no neoadjuvant or adjuvant treatment, absence of lymph node invasion, or distant metastasis confirmed by surgery or imaging. Comparisons were made between cases with only apex positive (AM), isolated nonapical positive (OM), multiple positive (MM), and negative surgical margins (NSM). Patients were also subdivided according to the Gleason score and pathological tumor stage for analysis. Results A total of 416 patients available for analysis, of which 132 (31.7%) were PSM, 43 were AM, 37 were OM, and 52 were MM at a median follow-up of 27 months. The PNI was in 30.5% of patients. BCR occurred in 22.6% of patients during follow-up. Both AM and MM were noticed to be independent predictors of BCR with a hazard ratio of 4.192 (95% CI 2.185–8.042; p < 0.001) and 2.758 (95% CI 1.559–4.880; p < 0.001), respectively, when compared to NSM. Though the correlation was significant in univariate analysis, PNI was not an independent risk factor for BCR (p = 0.369). Subgroup analyses suggested that MM was not particularly predictive for BCR in the Gleason score < 8. The hole Cox regression model for the C-index was 0.843 Conclusions PSM location was a significant independent predictor of BCR in PCa, especially in patients with AM or MM, while PNI is a non-independent risk factor. Compared with other locations, AM has a higher BCR risk.
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Affiliation(s)
- Zhenpeng Lian
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Hongtuan Zhang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Zhaowei He
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Shenfei Ma
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Xiaoming Wang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China.
| | - Ranlu Liu
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China.
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Pooli A, Salmasi A, Johnson DC, Lenis AT, Faiena I, Lebacle C, Golla V, Drakaki A, Gollapudi K, Blumberg J, Pantuck AJ, Chamie K. Positive surgical margins at radical prostatectomy in the United States: Institutional variations and predictive factors. Urol Oncol 2019; 38:1.e17-1.e23. [PMID: 31537483 DOI: 10.1016/j.urolonc.2019.08.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/12/2019] [Accepted: 08/20/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Positive surgical margins (PSMs) are associated with treatment failure after radical prostatectomy (RP) for patients with prostate cancer (CaP). We investigated institutional variations in PSM after RP, as well as clinical and demographic factors predicting PSM. PATIENTS AND METHODS Patients undergoing RP for clinically localized CaP were identified in the National Cancer Database in 2010 to 2013 and clinicodemographics were recorded. Treating institution was defined as academic (AMC) or nonacademic medical centers (nAMC). The primary outcome was the PSM rate. Multivariable logistic regression and propensity matching with inverse probability treatment weighing were used to both compare outcomes between AMC and nAMC and to identify predictors of PSM following RP. RESULTS A total of 167,260 patients met our inclusion criteria. PSM rate was significantly lower in patients treated at AMC (13,435, 18.9%) compared with 22,145 (23.0%) in those treated at nAMC (P < 0.01). The difference between PSM rate in AMC and nAMC was more pronounced in lower volume centers while it was not significant in higher volume centers. On multivariable analysis, age, race, prostate-specific antigen (PSA), biopsy Gleason score, comorbidity profile, insurance type, income, and treatment facility were significantly associated with PSM rate. CONCLUSION PSM rates appear to be lower at AMC and higher volume facilities, which can potentially reflect institutional differences in surgical quality. In addition, we identified several socioeconomic and demographic factors that contribute to the likelihood of PSM following RP for localized CaP, suggesting potential systematic variation in the quality of surgical care. The cause of this variation warrants further investigation and evaluation.
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Affiliation(s)
- Aydin Pooli
- Institute of Urologic Oncology (IUO) at UCLA, Department a of Urology, David Geffen School of Medicine, Los Angeles, CA.
| | - Amirali Salmasi
- Department of Urology, University of California, San Diego, CA
| | - David C Johnson
- Institute of Urologic Oncology (IUO) at UCLA, Department a of Urology, David Geffen School of Medicine, Los Angeles, CA; Department of Veterans Affairs/UCLA National Clinician Scholars Program, Los Angeles, CA
| | - Andrew T Lenis
- Institute of Urologic Oncology (IUO) at UCLA, Department a of Urology, David Geffen School of Medicine, Los Angeles, CA
| | - Izak Faiena
- Institute of Urologic Oncology (IUO) at UCLA, Department a of Urology, David Geffen School of Medicine, Los Angeles, CA
| | - Cedric Lebacle
- Institute of Urologic Oncology (IUO) at UCLA, Department a of Urology, David Geffen School of Medicine, Los Angeles, CA; Department of Urology, University Hospital Bicetre, APHP, University Paris-Saclay, Le Kremlin Bicetre, France
| | - Vishnukamal Golla
- Institute of Urologic Oncology (IUO) at UCLA, Department a of Urology, David Geffen School of Medicine, Los Angeles, CA
| | - Alexandra Drakaki
- Institute of Urologic Oncology (IUO) at UCLA, Department a of Urology, David Geffen School of Medicine, Los Angeles, CA; Department of Hematology and Oncology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Kiran Gollapudi
- Division of Urology, Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA
| | - Jeremy Blumberg
- Division of Urology, Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA
| | - Allan J Pantuck
- Institute of Urologic Oncology (IUO) at UCLA, Department a of Urology, David Geffen School of Medicine, Los Angeles, CA
| | - Karim Chamie
- Institute of Urologic Oncology (IUO) at UCLA, Department a of Urology, David Geffen School of Medicine, Los Angeles, CA
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Comparison of 18F-Fluciclovine PET/CT and 99mTc-MDP bone scan in detection of bone metastasis in prostate cancer. Nucl Med Commun 2019; 40:940-946. [DOI: 10.1097/mnm.0000000000001051] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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10
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Eissa A, Zoeir A, Sighinolfi MC, Puliatti S, Bevilacqua L, Del Prete C, Bertoni L, Azzoni P, Reggiani Bonetti L, Micali S, Bianchi G, Rocco B. "Real-time" Assessment of Surgical Margins During Radical Prostatectomy: State-of-the-Art. Clin Genitourin Cancer 2019; 18:95-104. [PMID: 31784282 DOI: 10.1016/j.clgc.2019.07.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/14/2019] [Accepted: 07/15/2019] [Indexed: 01/18/2023]
Abstract
Histopathologic examination of the pathologic specimens using hematoxylin & eosin stains represents the backbone of the modern pathology. It is time-consuming; thus, "real-time" assessment of prostatic and periprostatic tissue has gained special interest in the diagnosis and management of prostate cancer. The current study focuses on the review of the different available techniques for "real-time" evaluation of surgical margins during radical prostatectomy (RP). We performed a comprehensive search of the Medline database to identify all the articles discussing "real-time" or intraoperative assessment of surgical margins during RP. Several filters were applied to the search to include only English articles performed on human subjects and published between January 2000 and March 2019. The search revealed several options for pathologic assessment of surgical margins including intraoperative frozen sections, confocal laser endomicroscopy, optical spectroscopy, photodynamic diagnosis, optical coherence tomography, multiphoton microscopy, structured illumination microscopy, 3D augmented reality, and ex vivo fluorescence confocal microscope. Frozen section represents the gold standard technique for real-time pathologic examinations of surgical margins during RP; however, several other options showed promising results in the initial clinical trials, and considering the rapid development in the field of molecular and cellular imaging, some of these options may serve as an alternative to frozen section.
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Affiliation(s)
- Ahmed Eissa
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy; Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ahmed Zoeir
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy; Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Stefano Puliatti
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Bevilacqua
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Del Prete
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Laura Bertoni
- Department of Pathology, University of Modena and Reggio Emilia, Modena, Italy
| | - Paola Azzoni
- Department of Pathology, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Salvatore Micali
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giampaolo Bianchi
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Bernardo Rocco
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.
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Marcq G, Michelet A, Hannink G, Rizk J, Sauvain J, Villers A, Saffarini M, Rochat CH. Correction to: Risk of biochemical recurrence based on extent and location of positive surgical margins after robot-assisted laparoscopic radical prostatectomy. BMC Cancer 2019; 19:124. [PMID: 30732574 PMCID: PMC6366108 DOI: 10.1186/s12885-019-5296-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 01/08/2019] [Indexed: 11/28/2022] Open
Affiliation(s)
- Gautier Marcq
- Urology Department, CHU Lille, F-59000, Lille, France.,GIVRE - MERCS - Module for Education and Research Collaboration in Statistics, University of Lille, F-59000, Lille, France
| | - Aude Michelet
- ReSurg SA, Chemin de la Vuarpillière 35, 1260, Nyon, Switzerland
| | - Gerjon Hannink
- Orthopaedic Research Laboratory, Radboud University, Medical Center, POBox 9101, Nijmegen, 6500HB, The Netherlands
| | - Jerome Rizk
- Urology Department, CHU Lille, F-59000, Lille, France
| | - Jean Sauvain
- Urology Department, Clinique Générale Beaulieu, 1204, Genève, Switzerland
| | | | - Mo Saffarini
- ReSurg SA, Chemin de la Vuarpillière 35, 1260, Nyon, Switzerland.
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