Prediction of biochemical recurrence after laparoscopic radical prostatectomy
Abstract Background Radical prostatectomy (RP) has been considered primary treatment for localized prostate cancer. Biochemical recurrence (BCR) occur approximately 20–30% in five year after RP. We aim to develop a novel nomogram to predict BCR-free survival (BCRFS) and performed external validation...
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| 格式: | 文件 |
| 语言: | English |
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BMC
2023-11-01
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| 丛编: | BMC Urology |
| 主题: | |
| 在线阅读: | https://doi.org/10.1186/s12894-023-01350-2 |
| _version_ | 1827708107733598208 |
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| author | Tanan Bejrananda Pitchaya Pliensiri |
| author_facet | Tanan Bejrananda Pitchaya Pliensiri |
| author_sort | Tanan Bejrananda |
| collection | DOAJ |
| description | Abstract Background Radical prostatectomy (RP) has been considered primary treatment for localized prostate cancer. Biochemical recurrence (BCR) occur approximately 20–30% in five year after RP. We aim to develop a novel nomogram to predict BCR-free survival (BCRFS) and performed external validation using a validation cohort that may help clinicians to make better decision for tailoring adjuvant treatment to specific group of patients. Materials and methods This retrospective cohort study included 370 localized and regional prostate cancer patients who underwent laparoscopic radical prostatectomy (LRP) in Songklanagarind hospital between January 2010 and December 2019, the patients were divided into two groups (primary cohort and validation cohort). BCR-free survival was created using Kaplan-Meier curve. Predictive factors for BCR were identified with univariable and multivariable analysis using Cox proportional hazards model. Predictive nomogram was created using these identified factors and developed for the prediction of biochemical recurrence free survival (BCRFS) at 1 and 5 years after LRP. Results For primary Songklanagarind cohort, BCR was found in 105 patients (44.7%). Overall 1-year BCR-free survival was 52.8%, and 5-year BCR-free survival was 45.7% with median time to BCR of 18.1 months. Multivariable analysis identified unfavorable factor to BCRRF which are high initial serum PSA (> 20) (p < 0.001; HR 3.2), ISUP Gleason grade group > = 3 (p 0.033; HR 2.2), positive surgical margins (p 0.046; HR 1.5), and seminal vesicle involvement (p < 0.001; HR 5.2) and using for develop a novel nomogram to predict BCR. Concordance index 0.78. Conclusion Prostate cancer patients with unfavorable factors, including high initial PSA (> 20), ISUP Gleason grade group > = 3, positive margin and extra-prostatic tumor extension are considered high risks and independent predictors of biochemical recurrence. This predictive models could potentially improve the 1 and 5-year BCR prediction after RP, according to the study’s findings and will aid medical professionals in achieving the goal of clinical prediction and creating a proper management for the localized treatment of prostate cancer underwent laparoscopic radical prostatectomy. |
| first_indexed | 2024-03-10T16:58:09Z |
| format | Article |
| id | doaj.art-9008f6be4a6c4c66b2b05120fee85362 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-03-10T16:58:09Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-9008f6be4a6c4c66b2b05120fee853622023-11-20T11:03:21ZengBMCBMC Urology1471-24902023-11-0123111010.1186/s12894-023-01350-2Prediction of biochemical recurrence after laparoscopic radical prostatectomyTanan Bejrananda0Pitchaya Pliensiri1Division of Urology, Department of Surgery, Faculty of Medicine, Prince of Songkla UniversityDivision of Urology, Department of Surgery, Faculty of Medicine, Prince of Songkla UniversityAbstract Background Radical prostatectomy (RP) has been considered primary treatment for localized prostate cancer. Biochemical recurrence (BCR) occur approximately 20–30% in five year after RP. We aim to develop a novel nomogram to predict BCR-free survival (BCRFS) and performed external validation using a validation cohort that may help clinicians to make better decision for tailoring adjuvant treatment to specific group of patients. Materials and methods This retrospective cohort study included 370 localized and regional prostate cancer patients who underwent laparoscopic radical prostatectomy (LRP) in Songklanagarind hospital between January 2010 and December 2019, the patients were divided into two groups (primary cohort and validation cohort). BCR-free survival was created using Kaplan-Meier curve. Predictive factors for BCR were identified with univariable and multivariable analysis using Cox proportional hazards model. Predictive nomogram was created using these identified factors and developed for the prediction of biochemical recurrence free survival (BCRFS) at 1 and 5 years after LRP. Results For primary Songklanagarind cohort, BCR was found in 105 patients (44.7%). Overall 1-year BCR-free survival was 52.8%, and 5-year BCR-free survival was 45.7% with median time to BCR of 18.1 months. Multivariable analysis identified unfavorable factor to BCRRF which are high initial serum PSA (> 20) (p < 0.001; HR 3.2), ISUP Gleason grade group > = 3 (p 0.033; HR 2.2), positive surgical margins (p 0.046; HR 1.5), and seminal vesicle involvement (p < 0.001; HR 5.2) and using for develop a novel nomogram to predict BCR. Concordance index 0.78. Conclusion Prostate cancer patients with unfavorable factors, including high initial PSA (> 20), ISUP Gleason grade group > = 3, positive margin and extra-prostatic tumor extension are considered high risks and independent predictors of biochemical recurrence. This predictive models could potentially improve the 1 and 5-year BCR prediction after RP, according to the study’s findings and will aid medical professionals in achieving the goal of clinical prediction and creating a proper management for the localized treatment of prostate cancer underwent laparoscopic radical prostatectomy.https://doi.org/10.1186/s12894-023-01350-2NomogramPSA nadirPredictionBiochemical recurrenceRadical prostatectomy |
| spellingShingle | Tanan Bejrananda Pitchaya Pliensiri Prediction of biochemical recurrence after laparoscopic radical prostatectomy BMC Urology Nomogram PSA nadir Prediction Biochemical recurrence Radical prostatectomy |
| title | Prediction of biochemical recurrence after laparoscopic radical prostatectomy |
| title_full | Prediction of biochemical recurrence after laparoscopic radical prostatectomy |
| title_fullStr | Prediction of biochemical recurrence after laparoscopic radical prostatectomy |
| title_full_unstemmed | Prediction of biochemical recurrence after laparoscopic radical prostatectomy |
| title_short | Prediction of biochemical recurrence after laparoscopic radical prostatectomy |
| title_sort | prediction of biochemical recurrence after laparoscopic radical prostatectomy |
| topic | Nomogram PSA nadir Prediction Biochemical recurrence Radical prostatectomy |
| url | https://doi.org/10.1186/s12894-023-01350-2 |
| work_keys_str_mv | AT tananbejrananda predictionofbiochemicalrecurrenceafterlaparoscopicradicalprostatectomy AT pitchayapliensiri predictionofbiochemicalrecurrenceafterlaparoscopicradicalprostatectomy |