Digital rectal examination still plays a crucial role of predicting outcomes in the prostate cancer patients undergoing primary total prostate cryoablation
Purpose: In the management of prostate cancer (PC), outcome prediction using clinical stages determined via magnetic resonance imaging (MRI) or digital rectal examination (DRE) is controversial. Materials and Methods: Patients with PC who received primary total prostate cryoablation (PTPC) at our in...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Urological Science |
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| Online Access: | http://www.e-urol-sci.com/article.asp?issn=1879-5226;year=2023;volume=34;issue=4;spage=187;epage=193;aulast=Lin |
| _version_ | 1797221628631842816 |
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| author | Kuan-Hung Lin Tsung-Yi Hsieh Chung-Hsin Chen Yeong-Shiau Pu |
| author_facet | Kuan-Hung Lin Tsung-Yi Hsieh Chung-Hsin Chen Yeong-Shiau Pu |
| author_sort | Kuan-Hung Lin |
| collection | DOAJ |
| description | Purpose: In the management of prostate cancer (PC), outcome prediction using clinical stages determined via magnetic resonance imaging (MRI) or digital rectal examination (DRE) is controversial. Materials and Methods: Patients with PC who received primary total prostate cryoablation (PTPC) at our institution between October 2008 and March 2021 were enrolled in this study. The primary outcome was biochemical recurrence (BCR), which was defined according to the Phoenix criteria. The concordance of clinical stages determined via DRE and MRI was measured using the weighted kappa coefficient. The Cox proportional-hazards models were used to assess the BCR risks. Results: A total of 230 patients with a median age of 70 years were included in the analysis. The consensus rate of clinical T stages between DRE and MRI was 60.9% with fair concordance (κ = 0.310). DRE upstaged 25 (10.9%) patients, whereas MRI upstaged 65 (28.3%) patients. During the median follow-up duration of 83.1 months, BCR occurred in 78 patients. The univariate analysis of BCR revealed that initial prostate-specific antigen, Gleason sum, and DRE-determined T stage (T3a–b vs. T1-2c; hazard ratio [HR] 1.88; 95% confidence interval [CI] 1.2–2.94) were statistical predictors of BCR. However, no significant association was observed between MRI-determined T stage and BCR (T3a–b vs. T1-2c; HR 1.30; 95% CI 0.83–2.02). The multivariate models consisting of DRE-determined T stage were better than those consisting of MRI-determined T stage based on the Akaike information criteria. Conclusion: In the patients who underwent PTPC, DRE was a valuable technique for evaluating preoperative tumor status and predicting outcomes. |
| first_indexed | 2024-04-24T13:08:28Z |
| format | Article |
| id | doaj.art-68c069c2d11248e89fbb0090e49a8d5c |
| institution | Directory Open Access Journal |
| issn | 1879-5226 |
| language | English |
| last_indexed | 2024-04-24T13:08:28Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Urological Science |
| spelling | doaj.art-68c069c2d11248e89fbb0090e49a8d5c2024-04-05T05:13:41ZengWolters Kluwer Medknow PublicationsUrological Science1879-52262023-01-0134418719310.4103/UROS.UROS_139_22Digital rectal examination still plays a crucial role of predicting outcomes in the prostate cancer patients undergoing primary total prostate cryoablationKuan-Hung LinTsung-Yi HsiehChung-Hsin ChenYeong-Shiau PuPurpose: In the management of prostate cancer (PC), outcome prediction using clinical stages determined via magnetic resonance imaging (MRI) or digital rectal examination (DRE) is controversial. Materials and Methods: Patients with PC who received primary total prostate cryoablation (PTPC) at our institution between October 2008 and March 2021 were enrolled in this study. The primary outcome was biochemical recurrence (BCR), which was defined according to the Phoenix criteria. The concordance of clinical stages determined via DRE and MRI was measured using the weighted kappa coefficient. The Cox proportional-hazards models were used to assess the BCR risks. Results: A total of 230 patients with a median age of 70 years were included in the analysis. The consensus rate of clinical T stages between DRE and MRI was 60.9% with fair concordance (κ = 0.310). DRE upstaged 25 (10.9%) patients, whereas MRI upstaged 65 (28.3%) patients. During the median follow-up duration of 83.1 months, BCR occurred in 78 patients. The univariate analysis of BCR revealed that initial prostate-specific antigen, Gleason sum, and DRE-determined T stage (T3a–b vs. T1-2c; hazard ratio [HR] 1.88; 95% confidence interval [CI] 1.2–2.94) were statistical predictors of BCR. However, no significant association was observed between MRI-determined T stage and BCR (T3a–b vs. T1-2c; HR 1.30; 95% CI 0.83–2.02). The multivariate models consisting of DRE-determined T stage were better than those consisting of MRI-determined T stage based on the Akaike information criteria. Conclusion: In the patients who underwent PTPC, DRE was a valuable technique for evaluating preoperative tumor status and predicting outcomes.http://www.e-urol-sci.com/article.asp?issn=1879-5226;year=2023;volume=34;issue=4;spage=187;epage=193;aulast=Linbiochemical recurrencecryoablationdigital rectal examinationmagnetic resonance imagingoutcome predictionprostate cancer |
| spellingShingle | Kuan-Hung Lin Tsung-Yi Hsieh Chung-Hsin Chen Yeong-Shiau Pu Digital rectal examination still plays a crucial role of predicting outcomes in the prostate cancer patients undergoing primary total prostate cryoablation Urological Science biochemical recurrence cryoablation digital rectal examination magnetic resonance imaging outcome prediction prostate cancer |
| title | Digital rectal examination still plays a crucial role of predicting outcomes in the prostate cancer patients undergoing primary total prostate cryoablation |
| title_full | Digital rectal examination still plays a crucial role of predicting outcomes in the prostate cancer patients undergoing primary total prostate cryoablation |
| title_fullStr | Digital rectal examination still plays a crucial role of predicting outcomes in the prostate cancer patients undergoing primary total prostate cryoablation |
| title_full_unstemmed | Digital rectal examination still plays a crucial role of predicting outcomes in the prostate cancer patients undergoing primary total prostate cryoablation |
| title_short | Digital rectal examination still plays a crucial role of predicting outcomes in the prostate cancer patients undergoing primary total prostate cryoablation |
| title_sort | digital rectal examination still plays a crucial role of predicting outcomes in the prostate cancer patients undergoing primary total prostate cryoablation |
| topic | biochemical recurrence cryoablation digital rectal examination magnetic resonance imaging outcome prediction prostate cancer |
| url | http://www.e-urol-sci.com/article.asp?issn=1879-5226;year=2023;volume=34;issue=4;spage=187;epage=193;aulast=Lin |
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