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01-04-2020 | Prostate Cancer | Topic Paper

Development of a model to predict prostate cancer at the apex (PCAP model) in patients undergoing robot-assisted radical prostatectomy

Authors: Shivaram Cumarasamy, Alberto Martini, Ugo G. Falagario, Zeynep Gul, Alp T. Beksac, Isuru Jayaratna, George K. Haines III, Giuseppe Carrieri, Ash Tewari

Published in: World Journal of Urology | Issue 4/2020

Abstract

Purpose

To develop a model based on preoperative variables to predict apical prostate cancer.

Methods

We performed a retrospective analysis of 459 patients who underwent a robotic assisted radical prostatectomy (RALP) between January 2016 and September 2017. All patients had a preoperative biopsy and mpMRI of the prostate. Significant apical pathology (SAP) was defined as those patients who had a dominant nodule at the apex with a Gleason score > 6 and/or ECE at the apex. Binary logistic regression analyses were adopted to predict SAP. Variables included in the model were PSA, apical lesions prostate imaging reporting and data system (PI-RADS) score and apical biopsy Gleason score. The area under the curve (AUC) of the model was computed.

Results

A total of 121 (43.2%) patients had SAP. On univariable analysis, all apex-specific variables investigated emerged as predictors of SAP (all p < 0.05). On multivariable analysis PSA and apical PI-RADS score > 3 (all p < 0.05) emerged as significant predictors of SAP. The AUC of the model was 0.722.

Conclusion

Patients with PI-RADS 3, 4 or 5 lesions at the apex were three times as more likely to have true SAP compared to those who have PI-RADS < 3 or negative mpMRI prior to undergoing RALP.

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Title: Development of a model to predict prostate cancer at the apex (PCAP model) in patients undergoing robot-assisted radical prostatectomy
Authors: Shivaram Cumarasamy
Alberto Martini
Ugo G. Falagario
Zeynep Gul
Alp T. Beksac
Isuru Jayaratna
George K. Haines III
Giuseppe Carrieri
Ash Tewari
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Prostate Cancer
Prostatectomy
Prostatectomy
Published in: World Journal of Urology / Issue 4/2020
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02905-5

At a glance: The STEP trials

Springer Medicine

Development of a model to predict prostate cancer at the apex (PCAP model) in patients undergoing robot-assisted radical prostatectomy

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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