Enhanced precision in prostate surgery: determining key factors for rectal positive surgical margins through integrated imaging and clinical data analysis

ObjectiveThis study investigates the risk factors associated with rectal positive surgical margins (RPSM) following radical prostatectomy and aims to develop a predictive model.MethodsClinical data from 198 patients undergoing radical prostatectomy at the Department of Urology, Kunshan Hospital of T...

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Main Authors: Yufan Wu, Fei Liu, Shiyu Ma, Guodong Jing, Qiwei Yu, Linya Yao, Chengwei Shao, Weiguo Chen, Xingbo Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2025.1563344/full
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author Yufan Wu
Yufan Wu
Fei Liu
Shiyu Ma
Guodong Jing
Qiwei Yu
Linya Yao
Chengwei Shao
Weiguo Chen
Xingbo Wang
author_facet Yufan Wu
Yufan Wu
Fei Liu
Shiyu Ma
Guodong Jing
Qiwei Yu
Linya Yao
Chengwei Shao
Weiguo Chen
Xingbo Wang
author_sort Yufan Wu
collection DOAJ
description ObjectiveThis study investigates the risk factors associated with rectal positive surgical margins (RPSM) following radical prostatectomy and aims to develop a predictive model.MethodsClinical data from 198 patients undergoing radical prostatectomy at the Department of Urology, Kunshan Hospital of Traditional Chinese Medicine from June 2022 to June 2024 were analyzed. Patients were categorized into groups with and without RPSM. Univariate and multivariate logistic regression analyses identified independent predictors of RPSM. Utilizing R software, we generated a column chart illustrating prostate cancer's RPSM incidence and constructed ROC curves with the area under the curve (AUC) to assess the discriminative performance and calibration of our model.ResultsMultivariate logistic regression identified clinical stage, PSA level, Gleason score, bilateral prostate infiltration, and PI-RADS as significant predictors of RPSM (all P < 0.05). Using these predictors, we developed a nomogram that achieved a C-index of 0.833(95% CI: 0.785–0.887) and an AUC of 0.755 (95% CI: 0.645–0.866).ConclusionThe predictive model effectively forecasts the likelihood of RPSM following radical prostatectomy, offering valuable insights for personalized patient management.
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issn 2296-875X
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publishDate 2025-04-01
publisher Frontiers Media S.A.
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series Frontiers in Surgery
spelling doaj-art-bc04fb8d8ea542d99d212442354b013b2025-08-20T03:05:21ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-04-011210.3389/fsurg.2025.15633441563344Enhanced precision in prostate surgery: determining key factors for rectal positive surgical margins through integrated imaging and clinical data analysisYufan Wu0Yufan Wu1Fei Liu2Shiyu Ma3Guodong Jing4Qiwei Yu5Linya Yao6Chengwei Shao7Weiguo Chen8Xingbo Wang9Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, JiangSu, ChinaDepartment of Urology, Kunshan Sixth People’s Hospital, Kunshan, JiangSu, ChinaDepartment of Radiology, Changhai Hospital, Shanghai, ChinaDepartment of Radiology, Changhai Hospital, Shanghai, ChinaDepartment of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, JiangSu, ChinaDepartment of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, JiangSu, ChinaDepartment of Radiology, Changhai Hospital, Shanghai, ChinaDepartment of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Urology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, JiangSu, ChinaObjectiveThis study investigates the risk factors associated with rectal positive surgical margins (RPSM) following radical prostatectomy and aims to develop a predictive model.MethodsClinical data from 198 patients undergoing radical prostatectomy at the Department of Urology, Kunshan Hospital of Traditional Chinese Medicine from June 2022 to June 2024 were analyzed. Patients were categorized into groups with and without RPSM. Univariate and multivariate logistic regression analyses identified independent predictors of RPSM. Utilizing R software, we generated a column chart illustrating prostate cancer's RPSM incidence and constructed ROC curves with the area under the curve (AUC) to assess the discriminative performance and calibration of our model.ResultsMultivariate logistic regression identified clinical stage, PSA level, Gleason score, bilateral prostate infiltration, and PI-RADS as significant predictors of RPSM (all P < 0.05). Using these predictors, we developed a nomogram that achieved a C-index of 0.833(95% CI: 0.785–0.887) and an AUC of 0.755 (95% CI: 0.645–0.866).ConclusionThe predictive model effectively forecasts the likelihood of RPSM following radical prostatectomy, offering valuable insights for personalized patient management.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1563344/fullprostate cancerradical prostatectomyrectal positive surgical marginspredictive modelPI-RADS
spellingShingle Yufan Wu
Yufan Wu
Fei Liu
Shiyu Ma
Guodong Jing
Qiwei Yu
Linya Yao
Chengwei Shao
Weiguo Chen
Xingbo Wang
Enhanced precision in prostate surgery: determining key factors for rectal positive surgical margins through integrated imaging and clinical data analysis
Frontiers in Surgery
prostate cancer
radical prostatectomy
rectal positive surgical margins
predictive model
PI-RADS
title Enhanced precision in prostate surgery: determining key factors for rectal positive surgical margins through integrated imaging and clinical data analysis
title_full Enhanced precision in prostate surgery: determining key factors for rectal positive surgical margins through integrated imaging and clinical data analysis
title_fullStr Enhanced precision in prostate surgery: determining key factors for rectal positive surgical margins through integrated imaging and clinical data analysis
title_full_unstemmed Enhanced precision in prostate surgery: determining key factors for rectal positive surgical margins through integrated imaging and clinical data analysis
title_short Enhanced precision in prostate surgery: determining key factors for rectal positive surgical margins through integrated imaging and clinical data analysis
title_sort enhanced precision in prostate surgery determining key factors for rectal positive surgical margins through integrated imaging and clinical data analysis
topic prostate cancer
radical prostatectomy
rectal positive surgical margins
predictive model
PI-RADS
url https://www.frontiersin.org/articles/10.3389/fsurg.2025.1563344/full
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