Doporučené postupy pro praktické lékaře Doporučené diagnostické a terapeutické postupy pro všeobecné praktické lékaře
29 stran ; 30 cm
Brožura a směrnice, které se zaměřují na diagnostiku a léčbu nemocí ledvin. Určeno praktickým lékařům.
- MeSH
- Kidney Diseases diagnosis therapy MeSH
- General Practice MeSH
- Publication type
- Practice Guideline MeSH
- Conspectus
- Patologie. Klinická medicína
- NML Fields
- nefrologie
- všeobecné lékařství
- NML Publication type
- brožury
BACKGROUND: Prediction of side-specific extraprostatic extension (EPE) is crucial in selecting patients for nerve-sparing radical prostatectomy (RP). Multiple nomograms, which include magnetic resonance imaging (MRI) information, are available predict side-specific EPE. It is crucial that the accuracy of these nomograms is assessed with external validation to ensure they can be used in clinical practice to support medical decision-making. METHODS: Data of prostate cancer (PCa) patients that underwent robot-assisted RP (RARP) from 2017 to 2021 at four European tertiary referral centers were collected retrospectively. Four previously developed nomograms for the prediction of side-specific EPE were identified and externally validated. Discrimination (area under the curve [AUC]), calibration and net benefit of four nomograms were assessed. To assess the strongest predictor among the MRI features included in all nomograms, we evaluated their association with side-specific EPE using multivariate regression analysis and Akaike Information Criterion (AIC). RESULTS: This study involved 773 patients with a total of 1546 prostate lobes. EPE was found in 338 (22%) lobes. The AUCs of the models predicting EPE ranged from 72.2% (95% CI 69.1-72.3%) (Wibmer) to 75.5% (95% CI 72.5-78.5%) (Nyarangi-Dix). The nomogram with the highest AUC varied across the cohorts. The Soeterik, Nyarangi-Dix, and Martini nomograms demonstrated fair to good calibration for clinically most relevant thresholds between 5 and 30%. In contrast, the Wibmer nomogram showed substantial overestimation of EPE risk for thresholds above 25%. The Nyarangi-Dix nomogram demonstrated a higher net benefit for risk thresholds between 20 and 30% when compared to the other three nomograms. Of all MRI features, the European Society of Urogenital Radiology score and tumor capsule contact length showed the highest AUCs and lowest AIC. CONCLUSION: The Nyarangi-Dix, Martini and Soeterik nomograms resulted in accurate EPE prediction and are therefore suitable to support medical decision-making.
- MeSH
- Middle Aged MeSH
- Humans MeSH
- Magnetic Resonance Imaging * methods MeSH
- Prostatic Neoplasms * diagnostic imaging pathology surgery MeSH
- Nomograms * MeSH
- Prognosis MeSH
- Prostate diagnostic imaging pathology surgery MeSH
- Prostatectomy * methods MeSH
- Retrospective Studies 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
- MeSH
- Clinical Studies as Topic MeSH
- Humans MeSH
- Lymphoma etiology MeSH
- Risk Factors MeSH
- Tattooing * adverse effects MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
- News MeSH
- MeSH
- Health Services Accessibility MeSH
- Cardiac Surgical Procedures * economics MeSH
- Humans MeSH
- Fee-for-Service Plans MeSH
- Reimbursement, Incentive MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
- News MeSH
- Keywords
- týmová praxe,
- MeSH
- Primary Health Care * organization & administration MeSH
- Practice Management, Medical MeSH
- Group Practice MeSH
- Reimbursement, Incentive MeSH
- Publication type
- Newspaper Article MeSH
- News MeSH
