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.
- MeSH
- Algorithms * MeSH
- Risk Assessment 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
European urology ; vol. 53, iss. 5, May 2008 Surgery in motion
1 DVD ; 13 cm
