Incidence and Predicting Factors of Histopathological Features at Robot-Assisted Radical Prostatectomy in the mpMRI Era: Results of a Single Tertiary Referral Center
Author:
Di Mauro Ernesto1, Di Bello Francesco1, Califano Gianluigi1, Morra Simone1ORCID, Creta Massimiliano1ORCID, Celentano Giuseppe1, Abate Marco1, Fraia Agostino1, Pezone Gabriele1, Marino Claudio1, Cilio Simone1, Capece Marco1, La Rocca Roberto1, Imbimbo Ciro1, Longo Nicola1, Colla’ Ruvolo Claudia1ORCID
Affiliation:
1. Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Via Sergio Pansini 5, 80131 Naples, Italy
Abstract
Background and Objectives: To describe the predictors of cribriform variant status and perineural invasion (PNI) in robot-assisted radical prostatectomy (RARP) histology. To define the rates of upgrading between biopsy specimens and final histology and their possible predictive factors in prostate cancer (PCa) patients undergoing RARP. Material and Methods: Within our institutional database, 265 PCa patients who underwent prostate biopsies and consecutive RARP at our center were enrolled (2018–2022). In the overall population, two independent multivariable logistic regression models (LRMs) predicting the presence of PNI or cribriform variant status at RARP were performed. In low- and intermediate-risk PCa patients according to D’Amico risk classification, three independent multivariable LRMs were fitted to predict upgrading. Results: Of all, 30.9% were low-risk, 18.9% were intermediate-risk and 50.2% were high-risk PCa patients. In the overall population, the rates of the cribriform variant and PNI at RARP were 55.8% and 71.1%, respectively. After multivariable LRMs predicting PNI, total tumor length in biopsy cores (>24 mm [OR: 2.37, p-value = 0.03], relative to <24 mm) was an independent predictor. After multivariable LRMs predicting cribriform variant status, PIRADS (3 [OR:15.37], 4 [OR: 13.57] or 5 [OR: 16.51] relative to PIRADS 2, all p = 0.01) and total tumor length in biopsy cores (>24 mm [OR: 2.47, p = 0.01], relative to <24 mm) were independent predicting factors. In low- and intermediate-risk PCa patients, the rate of upgrading was 74.4% and 78.0%, respectively. After multivariable LRMs predicting upgrading, PIRADS (PIRADS 3 [OR: 7.01], 4 [OR: 16.98] or 5 [OR: 20.96] relative to PIRADS 2, all p = 0.01) was an independent predicting factor. Conclusions: RARP represents a tailored and risk-adapted treatment strategy for PCa patients. The indication of RP progressively migrates to high-risk PCa after a pre-operative assessment. Specifically, the PIRADS score at mpMRI should guide the decision-making process of urologists for PCa patients.
Reference66 articles.
1. EAU Guidelines on Prostate Cancer—Uroweb [Internet] (2022, April 24). Uroweb—European Association of Urology. Available online: https://uroweb.org/guidelines/prostate-cancer. 2. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012;Ferlay;Int. J. Cancer,2015 3. Prostate cancer risk prediction based on complete prostate cancer family history;Albright;Prostate,2015 4. Celentano, G., Creta, M., Napolitano, L., Abate, M., La Rocca, R., Capece, M., Mirone, C., Morra, S., Di Bello, F., and Cirillo, L. (2022). Prostate Cancer Diagnosis, Treatment and Outcomes in Patients with Previous or Synchronous Colorectal Cancer: A Systematic Review of Published Evidence. Diagnostics, 12. 5. Scandurra, C., Muzii, B., La Rocca, R., Di Bello, F., Bottone, M., Califano, G., Longo, N., Maldonato, N.M., and Mangiapia, F. (2022). Social Support Mediates the Relationship between Body Image Distress and Depressive Symptoms in Prostate Cancer Patients. Int. J. Environ. Res. Public Health, 19.
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|