External validation of an algorithm to personalize nerve sparing approaches during robot-assisted radical prostatectomy in men with unilateral high-risk prostate cancer
Language English Country England, Great Britain Media print-electronic
Document type Journal Article, Validation Study
PubMed
38177256
DOI
10.1038/s41391-023-00779-8
PII: 10.1038/s41391-023-00779-8
Knihovny.cz E-resources
- MeSH
- Algorithms * MeSH
- Risk Assessment MeSH
- Precision Medicine methods MeSH
- Organ Sparing Treatments * methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Prostatic Neoplasms * surgery pathology MeSH
- Nomograms MeSH
- Prostate * surgery innervation pathology MeSH
- Prostatectomy * methods MeSH
- Robotic Surgical Procedures * methods MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Validation Study 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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