机构：[1]Department of Urology, Institute of Urology, and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.四川大学华西医院
To investigate potential preoperative predictors of urethral or apical positive surgical margin (PSM) and the value of apical prostate biopsy in predicting urethral/apical margin status after radical prostatectomy (RP).
A total of 531 patients who underwent RP during 2010 to 2017 at West China Hospital were enrolled in this retrospective study. Preoperative and postoperative factors including age, BMI, PSA, clinical T stage and biopsy Gleason score were analyzed. Univariate analysis and logistic regression were used to find out the potential predictive factors for PSM. Two logistic regression models were built to evaluate the role of apical prostate biopsy in predicting urethral/apical margin status.
The overall PSM rate was about 30.1% (160/531) and 97 of them were reported urethral/apical PSM. The incidence of urethral or apical PSM in patients with positive cores in the apical prostate was higher than those without (23.0% vs 9.9%, P < .001). We further found that the multivariable model with positive apical prostate biopsy could significantly increase the predictive value of urethral or apical PSM status (AUC: 0.744 vs 0.783, P = .016). Our analysis also showed that neo-adjuvant hormone therapy was an independent protective factor for urethral or apical PSM in patients with positive apical prostate biopsy, but not all patients.
This study revealed the necessity of apical prostate biopsy to predict the risk of apical or urethral PSM. In clinical practice, neo-adjuvant hormone therapy should be given when patients with positive apical prostate biopsy to reduce the presence of PSM, especially patients with high/very high risk prostate cancer.
基金：
National Clinical Research Center for Geriatrics,
West China Hospital, Sichuan University (Z2018A01), National Natural Science
Foundation of China (NSFC 81402110 and 81672547); Science and Technology
Support Program of Sichuan Province (2015SZ0142); 1.3.5 project for disciplines
of excellence, West China Hospital, Sichuan University.
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2019]版：
大类|4 区医学
小类|3 区医学：内科
最新[2023]版：
大类|4 区医学
小类|4 区医学：内科
第一作者：
第一作者机构：[1]Department of Urology, Institute of Urology, and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
共同第一作者：
通讯作者：
通讯机构：[1]Department of Urology, Institute of Urology, and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.[*1]Department of Urology, Institute of Urology, and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu 610041, China
推荐引用方式(GB/T 7714)：
Dai Jindong,Zhang Xingming,Zhao Jinge,et al.The value of transperineal apical prostate biopsy in predicting urethral/apical margin status after radical prostatectomy.[J].Medicine.2019,98(43):e17633.doi:10.1097/MD.0000000000017633.
APA：
Dai Jindong,Zhang Xingming,Zhao Jinge,Sun Guangxi,Chen Junru...&Shen Pengfei.(2019).The value of transperineal apical prostate biopsy in predicting urethral/apical margin status after radical prostatectomy..Medicine,98,(43)
MLA：
Dai Jindong,et al."The value of transperineal apical prostate biopsy in predicting urethral/apical margin status after radical prostatectomy.".Medicine 98..43(2019):e17633
