Development and external validation of a new nomogram to predict side-specific extraprostatic extension in patients with prostate cancer undergoing robot assisted radical prostatectomy (RARP)

2019 ◽  
Vol 18 (6) ◽  
pp. e2591
Author(s):  
T. Soeterik ◽  
H.H.E. Van Melick ◽  
L.M. Dijksman ◽  
H. Küsters-Van De Velde ◽  
I.G. Schoots ◽  
...  
2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 106-106
Author(s):  
Rubin Pinkhasov ◽  
Alexandr M. Pinkhasov ◽  
Kristopher Attwood ◽  
Michall Abaev ◽  
Willie Underwood

106 Background: Using previously developed prostatectomy incontinence nomogram (PIN) we sought to externally validate the nomogram that predicts probability of incontinence at 6-, 12-, and 24-months after robot assisted radical prostatectomy (RARP). Methods: Prospective data from 663 men with prostate cancer that underwent RARP from 2010 to 2014 at two comprehensive cancer centers and three large group practices was queried. The performance of the previously developed model was evaluated using calibration plots (predicted continence rates versus observed continence rates with 95% CI obtained using Jeffrey’s prior method) and receiver operating curves (ROC). Using Expanded Prostate Cancer Index Composite (EPIC-50) Urinary Function questionnaire, perfect continence was defined as 0 pads, social continence was defined as 1 or 2 pads, and incontinence was defined as ≥ 3 pads used after RARP. Results: The 6-, 12-, and 24- month social continence rates were 77%, 88%, and 93%, respectively. Similar to the 6- and 12-month model development cohort, the external validation cohort has modest predictability with a 6- and 12- month AUC of 0.61, and 0.62, respectively. The 24-month AUC of 0.62 in the external validation cohort is worse than what was reported in the development cohort (AUC 0.80). Conclusions: The externally validated prostatectomy incontinence nomogram is generalizable but has modest 6-, 12-, and 12-month predictability in risk of incontinence after RARP.


Author(s):  
Antonio Benito Porcaro ◽  
Alessandro Tafuri ◽  
Riccardo Rizzetto ◽  
Nelia Amigoni ◽  
Marco Sebben ◽  
...  

AbstractTo investigate factors associated with the risk of major complications after radical prostatectomy (RP) by the open (ORP) or robot-assisted (RARP) approach for prostate cancer (PCa) in a tertiary referral center. 1062 consecutive patients submitted to RP were prospectively collected. The following outcomes were addressed: (1) overall postoperative complications: subjects with Clavien-Dindo System (CD) one through five versus cases without any complication; (2) moderate to major postoperative complications: cases with CD < 2 vs.  ≥ 2, and 3) major post-operative complications: subjects with CDS CD ≥  3 vs.  < 3. The association of pre-operative and intra-operative factors with the risk of postoperative complications was assessed by the logistic regression model. Overall, complications occurred in 310 out of 1062 subjects (29.2%). Major complications occurred in 58 cases (5.5%). On multivariate analysis, major complications were predicted by PCa surgery and intraoperative estimated blood loss (EBL). ORP compared to RARP increased the risk of major CD complications from 2.8 to 19.3% (OR = 8283; p < 0.0001). Performing ePLND increased the risk of major complications from 2.4 to 7.4% (OR = 3090; p < 0.0001). Assessing intraoperative blood loss, the risk of major postoperative complications was increased by BL above the third quartile when compared to subjects with intraoperative blood loss up to the third quartile (10.2% vs. 4.6%; OR = 2239; 95%CI: 1233–4064). In the present cohort, radical prostatectomy showed major postoperative complications that were independently predicted by the open approach, extended lymph-node dissection, and excessive intraoperative blood loss.


2016 ◽  
Vol 195 (4S) ◽  
Author(s):  
Dae Keun Kim ◽  
Atalla Alatawi ◽  
Abulhasan Sheikh ◽  
Ibrahim Alabdulaali ◽  
Ali Abdel Raheem ◽  
...  

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