Biochemical recurrence prediction after robot-assited radical prostatectomy (BCR-PRARP)

Objective: This study aimed to establish a robust predictive model for biochemical recurrence (BCR) in patients with prostate cancer who underwent robot-Assisted Radical Prostatectomy. Material and methods: A cohort of 1700 patients who underwent robot-assisted radical prostatectomy (RARP) for prost...

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Main Authors: Tanan Bejrananda, Kiyoshi Takahara, Dutsadee Sowanthip, Tomonari Motonaga, Kota Yagi, Wataru Nakamura, Masanobu Saruta, Takuhisa Nukaya, Masashi Takenaka, Kenji Zennami, Manabu Ichino, Hitomi Sasaki, Makoto Sumitomo, Ryoichi Shiroki
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Heliyon
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405844024170624
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author Tanan Bejrananda
Kiyoshi Takahara
Dutsadee Sowanthip
Tomonari Motonaga
Kota Yagi
Wataru Nakamura
Masanobu Saruta
Takuhisa Nukaya
Masashi Takenaka
Kenji Zennami
Manabu Ichino
Hitomi Sasaki
Makoto Sumitomo
Ryoichi Shiroki
author_facet Tanan Bejrananda
Kiyoshi Takahara
Dutsadee Sowanthip
Tomonari Motonaga
Kota Yagi
Wataru Nakamura
Masanobu Saruta
Takuhisa Nukaya
Masashi Takenaka
Kenji Zennami
Manabu Ichino
Hitomi Sasaki
Makoto Sumitomo
Ryoichi Shiroki
author_sort Tanan Bejrananda
collection DOAJ
description Objective: This study aimed to establish a robust predictive model for biochemical recurrence (BCR) in patients with prostate cancer who underwent robot-Assisted Radical Prostatectomy. Material and methods: A cohort of 1700 patients who underwent robot-assisted radical prostatectomy (RARP) for prostate cancer between August 2009 and December 2022 was included. BCR was defined as two consecutive PSA levels exceeding 0.2 ng/mL post-radical prostatectomy. Cox proportional hazards regression identified predictive variables for BCR. Subsequently, pathologic T stage, PSA level, positive surgical margin, extraprostatic extension, and seminal vesicle involvement were retained. A nomogram was constructed using R software to predict BCR. The model was evaluated using the C-index and calibration curves. Results: A total of 161 instances of BCR were observed during a median follow-up of 61.0 months (range, 12–162 months). The 5-year BCR-free survival rate for the cohort was 25 %. Univariate analysis demonstrated significant associations between BCR and PSA, clinical T stage, biopsy Gleason score, D'Amico risk classification, pathologic T stage, pathologic Gleason score, extraprostatic extension, seminal vesicle invasion, and positive surgical margins. Multivariate analysis identified high PSA ≥20 ng/mL (HR: 1.93; p = 0.034), pathologic T stage 3–4 (HR: 1.89; p < 0.001), pathologic Gleason score 8–10 (HR: 5.43; p < 0.001), extraprostatic extension (HR: 1.41; p < 0.001), seminal vesicle involvement (HR: 1.92; p = 0.018), and positive surgical margin (HR: 2.73; p < 0.001) as independent predictors of BCR. The new model exhibited a C-index of 0.743 (95 % confidence interval: 0.741–0.745). Conclusion: The developed nomogram accurately predicts the likelihood of BCR-free status within 3 years following RARP. This allows for tailored follow-up strategies, optimizing resource allocation, and holds significant clinical utility, warranting broader implementation and further research.
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spelling doaj-art-e0a1ee5c03b74f008f4337ab7cdc2ba72025-08-20T03:00:57ZengElsevierHeliyon2405-84402025-01-01111e4103110.1016/j.heliyon.2024.e41031Biochemical recurrence prediction after robot-assited radical prostatectomy (BCR-PRARP)Tanan Bejrananda0Kiyoshi Takahara1Dutsadee Sowanthip2Tomonari Motonaga3Kota Yagi4Wataru Nakamura5Masanobu Saruta6Takuhisa Nukaya7Masashi Takenaka8Kenji Zennami9Manabu Ichino10Hitomi Sasaki11Makoto Sumitomo12Ryoichi Shiroki13Division of Urology, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand; Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; Corresponding author. Division of Urology, Department of Surgery, Faculty of Medicine, Prince of Songkla Universit, Hat Yai, Songkhla, 90110, Thailand.Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, JapanDepartment of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; Division of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, ThailandDepartment of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, JapanDepartment of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, JapanDepartment of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, JapanDepartment of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, JapanDepartment of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, JapanDepartment of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, JapanDepartment of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, JapanDepartment of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, JapanDepartment of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, JapanDepartment of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, JapanDepartment of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, JapanObjective: This study aimed to establish a robust predictive model for biochemical recurrence (BCR) in patients with prostate cancer who underwent robot-Assisted Radical Prostatectomy. Material and methods: A cohort of 1700 patients who underwent robot-assisted radical prostatectomy (RARP) for prostate cancer between August 2009 and December 2022 was included. BCR was defined as two consecutive PSA levels exceeding 0.2 ng/mL post-radical prostatectomy. Cox proportional hazards regression identified predictive variables for BCR. Subsequently, pathologic T stage, PSA level, positive surgical margin, extraprostatic extension, and seminal vesicle involvement were retained. A nomogram was constructed using R software to predict BCR. The model was evaluated using the C-index and calibration curves. Results: A total of 161 instances of BCR were observed during a median follow-up of 61.0 months (range, 12–162 months). The 5-year BCR-free survival rate for the cohort was 25 %. Univariate analysis demonstrated significant associations between BCR and PSA, clinical T stage, biopsy Gleason score, D'Amico risk classification, pathologic T stage, pathologic Gleason score, extraprostatic extension, seminal vesicle invasion, and positive surgical margins. Multivariate analysis identified high PSA ≥20 ng/mL (HR: 1.93; p = 0.034), pathologic T stage 3–4 (HR: 1.89; p < 0.001), pathologic Gleason score 8–10 (HR: 5.43; p < 0.001), extraprostatic extension (HR: 1.41; p < 0.001), seminal vesicle involvement (HR: 1.92; p = 0.018), and positive surgical margin (HR: 2.73; p < 0.001) as independent predictors of BCR. The new model exhibited a C-index of 0.743 (95 % confidence interval: 0.741–0.745). Conclusion: The developed nomogram accurately predicts the likelihood of BCR-free status within 3 years following RARP. This allows for tailored follow-up strategies, optimizing resource allocation, and holds significant clinical utility, warranting broader implementation and further research.http://www.sciencedirect.com/science/article/pii/S2405844024170624NomogramsProstatectomyPredictionBiochemical recurrenceRobot-assisted
spellingShingle Tanan Bejrananda
Kiyoshi Takahara
Dutsadee Sowanthip
Tomonari Motonaga
Kota Yagi
Wataru Nakamura
Masanobu Saruta
Takuhisa Nukaya
Masashi Takenaka
Kenji Zennami
Manabu Ichino
Hitomi Sasaki
Makoto Sumitomo
Ryoichi Shiroki
Biochemical recurrence prediction after robot-assited radical prostatectomy (BCR-PRARP)
Heliyon
Nomograms
Prostatectomy
Prediction
Biochemical recurrence
Robot-assisted
title Biochemical recurrence prediction after robot-assited radical prostatectomy (BCR-PRARP)
title_full Biochemical recurrence prediction after robot-assited radical prostatectomy (BCR-PRARP)
title_fullStr Biochemical recurrence prediction after robot-assited radical prostatectomy (BCR-PRARP)
title_full_unstemmed Biochemical recurrence prediction after robot-assited radical prostatectomy (BCR-PRARP)
title_short Biochemical recurrence prediction after robot-assited radical prostatectomy (BCR-PRARP)
title_sort biochemical recurrence prediction after robot assited radical prostatectomy bcr prarp
topic Nomograms
Prostatectomy
Prediction
Biochemical recurrence
Robot-assisted
url http://www.sciencedirect.com/science/article/pii/S2405844024170624
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