External validation of an algorithm to personalize nerve sparing approaches during robot-assisted radical prostatectomy in men with unilateral high-risk prostate cancer
Jazyk angličtina Země Anglie, Velká Británie Médium print-electronic
Typ dokumentu časopisecké články, validační studie
PubMed
38177256
DOI
10.1038/s41391-023-00779-8
PII: 10.1038/s41391-023-00779-8
Knihovny.cz E-zdroje
- MeSH
- algoritmy * MeSH
- hodnocení rizik MeSH
- individualizovaná medicína metody MeSH
- léčba šetřící orgány * metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory prostaty * chirurgie patologie MeSH
- nomogramy MeSH
- prostata * chirurgie inervace patologie MeSH
- prostatektomie * metody MeSH
- roboticky asistované výkony * metody MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- validační studie MeSH
Limited evidence exists about preserving neurovascular bundles during radical prostatectomy (RP) for high-risk prostate cancer (HRPCa) patients. Hence, we validated an existing algorithm predicting contralateral extraprostatic extension (cEPE) risk in unilateral high-risk cases. This algorithm aims to assist in determining the suitability of unilateral nerve-sparing RP. Among 264 patients, 48 (18%) had cEPE. The risk of cECE varied: 8%, 17.2%, and 30.8% for the low, intermediate, and high-risk groups, respectively. Despite a higher risk of cECE among individuals classified as low-risk in the development group compared to the validation group, our algorithm's superiority over always/never nerve-sparing RP was reaffirmed by decision curve analysis. Therefore, we conclude that bilateral excision may not always be justified in men with unilateral HRPCa. Instead, decisions can be based on our suggested nomogram.
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Urology Geneva University Hospital Geneva Switzerland
Department of Urology Institut Mutualiste Montsouris Paris France
Department of Urology Medical University of Silesia Zabrze Poland
Department of Urology San Giovanni Battista Hospital University of Turin Turin Italy
Department of Urology University of Texas Southwestern Dallas TX USA
Department of Urology Weill Cornell Medical College New York NY USA
Hourani Center for Applied Scientific Research Al Ahliyya Amman University Amman Jordan
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