The predictive value of machine learning and nomograms for lymph node metastasis of prostate cancer: a systematic review and meta-analysis

Wang, Hao; Xia, Zhongyou; Xu, Yulai; Sun, Jing; Wu, Ji

doi:10.1038/s41391-023-00704-z

Cited by 3 publications

(1 citation statement)

References 61 publications

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“…Regarding postoperative factors, index tumors located in the central zone were of significantly higher prostatectomy ISUP grades and pathological T stages (both p < 0.05) when compared to those in other index tumor locations, as evidenced by pathological extraprostatic extension, seminal vesicle invasion, and bladder neck involvement. The significance of lymph node dissection in radical prostatectomy varies [ 15 ]. At our institution, the attending physician performed lymph node dissection based on the patient's cancer status and treatment era.…”

Section: Resultsmentioning

confidence: 99%

Index tumor location affected early biochemical recurrence after radical prostatectomy in patients with negative surgical margin: a retrospective study

Ogata,

Akatsuka,

Endo

et al. 2024

BMC Urol

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Background Index tumors are the most aggressive tumors of the prostate. However, their clinical significance remains unclear. This study aimed to assess the incidence of index tumor location according to the zonal origin and whether these locations affect the prognosis after radical prostatectomy in patients with negative surgical margins. Methods This single-centered, retrospective study evaluated 1,109 consecutive patients who underwent radical prostatectomies. An index tumor was defined as the largest tumor in the prostate gland. We detected these locations based on McNeal's zonal origin using whole-mount sections. Biochemical recurrence (BCR) free survival curves were generated using the Kaplan–Meier method. Univariate and multivariate analyses using the Cox proportional hazards model were performed to determine the predictive factors for early BCR (within 1-year). Results A total of 621 patients with negative surgical margins who did not receive adjuvant therapy were included in this study. The index tumor were located in the transitional zone in 191 patients (30.8%), the peripheral zone in 399 patients (64.3%), and the central zone in 31 patients (5.0%). In total, 22 of 621 patients (3.5%) experienced early BCR and 70 patients (11.2%) experienced overall BCR at a median follow-up of 61.7 months. According to the index tumor location, the early BCR-free rates were 99.5%, 95.7 %, and 83.3% in the transitional, peripheral, and central zones, respectively. On multivariate analysis, the index tumor in the central zone was an independent predictor of early BCR with negative surgical margins following radical prostatectomy, followed by prostatectomy pathological grade, index tumor in the peripheral zone, and high prostate-specific antigen level. Conclusions We assessed the significance of index tumor location in patients with negative surgical margins following radical prostatectomy. Index tumors located in the central zone, although infrequent, were the strongest predictive factors for early BCR. Our results may allow urologists and patients to reconsider the therapeutic strategies for prostate cancer.

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Section: Resultsmentioning

confidence: 99%