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Abstract：
UNASSIGNED: The objective of this study is to identify the effect of cribriform pattern 4 carcinoma/intraductal carcinoma of the prostate (CC/IDCP) on persistent prostate-specific antigen (PSA) levels after robot-assisted radical prostatectomy (RARP) in patients with localized prostate cancer (PCa).
UNASSIGNED: This retrospective study included 730 consecutive patients with localized PCa who underwent RARP at Mie University (n = 392) and Aichi Medical University (n = 338) between 2015 and 2021. Patients with clinically metastatic PCa (cN1 and cM1) and those who received neoadjuvant and/or adjuvant therapy before biochemical recurrence were excluded. We evaluated the effects of CC/IDCP on persistent PSA levels after RARP. Persistent PSA was defined as PSA level ≥0.2 ng/mL at 1 month postoperatively and consecutively thereafter. Using factors from logistic regression analysis, models were developed to predict persistent PSA levels.
UNASSIGNED: Approximately 6.3% (n = 46) of the patients had persistent PSA levels. Patients with biopsy CC/IDCP (bCC/IDCP) and pathological CC/IDCP (pCC/IDCP) based on RARP specimens were 11.6% (85/730) and 36.5% (267/730), respectively. Multivariate analysis of the prediction of persistent PSA levels using preoperative factors revealed that PSA density, percentage of positive cancer cores, biopsy grade group and bCC/IDCP were independent prognostic factors. Furthermore, multivariate analysis of the prediction of persistent PSA levels using postoperative factors, excluding pN1, revealed that pathological grade group, pCC/IDCP, seminal vesicle invasion and lymphovascular invasion were independent prognostic factors. In the receiver operating characteristic curve analysis for predicting persistent PSA after RARP, areas under the receiver operating characteristic curve for the model with preoperative factors, postoperative factors, including pN1, and postoperative factors, excluding pN1, were 0.827, 0.833 and 0.834, respectively.
UNASSIGNED: bCC/IDCP predicted persistent PSA after RARP in the overall population, while pCC/IDCP predicted persistent PSA only when the pN1 population was excluded. This may be useful for predicting susceptible patients with worse outcomes.
UNASSIGNED: This retrospective study included 730 consecutive patients with localized PCa who underwent RARP at Mie University (n = 392) and Aichi Medical University (n = 338) between 2015 and 2021. Patients with clinically metastatic PCa (cN1 and cM1) and those who received neoadjuvant and/or adjuvant therapy before biochemical recurrence were excluded. We evaluated the effects of CC/IDCP on persistent PSA levels after RARP. Persistent PSA was defined as PSA level ≥0.2 ng/mL at 1 month postoperatively and consecutively thereafter. Using factors from logistic regression analysis, models were developed to predict persistent PSA levels.
UNASSIGNED: Approximately 6.3% (n = 46) of the patients had persistent PSA levels. Patients with biopsy CC/IDCP (bCC/IDCP) and pathological CC/IDCP (pCC/IDCP) based on RARP specimens were 11.6% (85/730) and 36.5% (267/730), respectively. Multivariate analysis of the prediction of persistent PSA levels using preoperative factors revealed that PSA density, percentage of positive cancer cores, biopsy grade group and bCC/IDCP were independent prognostic factors. Furthermore, multivariate analysis of the prediction of persistent PSA levels using postoperative factors, excluding pN1, revealed that pathological grade group, pCC/IDCP, seminal vesicle invasion and lymphovascular invasion were independent prognostic factors. In the receiver operating characteristic curve analysis for predicting persistent PSA after RARP, areas under the receiver operating characteristic curve for the model with preoperative factors, postoperative factors, including pN1, and postoperative factors, excluding pN1, were 0.827, 0.833 and 0.834, respectively.
UNASSIGNED: bCC/IDCP predicted persistent PSA after RARP in the overall population, while pCC/IDCP predicted persistent PSA only when the pN1 population was excluded. This may be useful for predicting susceptible patients with worse outcomes.
摘要：
■这项研究的目的是确定在局部前列腺癌（PCa）患者中，机器人辅助根治性前列腺切除术（RARP）后，筛状模式4癌/前列腺导管内癌（CC/IDCP）对持续前列腺特异性抗原（PSA）水平的影响。
■这项回顾性研究包括在2015年至2021年期间在三重大学（n=392）和爱知医科大学（n=338）接受RARP治疗的730例局部PCa患者。排除患有临床转移性PCa（cN1和cM1）的患者以及在生化复发之前接受新辅助和/或辅助治疗的患者。我们评估了CC/IDCP对RARP后持续PSA水平的影响。持续PSA定义为术后1个月及之后连续PSA水平≥0.2ng/mL。利用Logistic回归分析的因素，建立了预测持续PSA水平的模型。
■大约6.3%(n=46)的患者有持续的PSA水平。基于RARP标本的活检CC/IDCP（bCC/IDCP）和病理CC/IDCP（pCC/IDCP）的患者分别为11.6％（85/730）和36.5％（267/730），分别。使用术前因素预测持续PSA水平的多变量分析显示，PSA密度，阳性癌症核心的百分比，活检分级组和bCC/IDCP是独立的预后因素。此外，使用术后因素预测持续PSA水平的多变量分析，排除pN1，显示病理分级组，pCC/IDCP,精囊浸润和淋巴血管浸润是独立的预后因素。在预测RARP后持续性PSA的受试者工作特征曲线分析中，受术前因素影响的模型的接受者工作特性曲线下的面积，术后因素，包括pN1和术后因素，不包括pN1，分别为0.827、0.833和0.834。
■bCC/IDCP预测了整个人群中RARP后的持续性PSA，而pCC/IDCP仅在排除pN1人群时才预测持续PSA。这对于预测结果较差的易感患者可能是有用的。
■这项回顾性研究包括在2015年至2021年期间在三重大学（n=392）和爱知医科大学（n=338）接受RARP治疗的730例局部PCa患者。排除患有临床转移性PCa（cN1和cM1）的患者以及在生化复发之前接受新辅助和/或辅助治疗的患者。我们评估了CC/IDCP对RARP后持续PSA水平的影响。持续PSA定义为术后1个月及之后连续PSA水平≥0.2ng/mL。利用Logistic回归分析的因素，建立了预测持续PSA水平的模型。
■大约6.3%(n=46)的患者有持续的PSA水平。基于RARP标本的活检CC/IDCP（bCC/IDCP）和病理CC/IDCP（pCC/IDCP）的患者分别为11.6％（85/730）和36.5％（267/730），分别。使用术前因素预测持续PSA水平的多变量分析显示，PSA密度，阳性癌症核心的百分比，活检分级组和bCC/IDCP是独立的预后因素。此外，使用术后因素预测持续PSA水平的多变量分析，排除pN1，显示病理分级组，pCC/IDCP,精囊浸润和淋巴血管浸润是独立的预后因素。在预测RARP后持续性PSA的受试者工作特征曲线分析中，受术前因素影响的模型的接受者工作特性曲线下的面积，术后因素，包括pN1和术后因素，不包括pN1，分别为0.827、0.833和0.834。
■bCC/IDCP预测了整个人群中RARP后的持续性PSA，而pCC/IDCP仅在排除pN1人群时才预测持续PSA。这对于预测结果较差的易感患者可能是有用的。
