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05.12.2016 | Original Article – Clinical Oncology | Ausgabe 4/2017

Journal of Cancer Research and Clinical Oncology 4/2017

Preoperative characteristics of the P.R.O.S.T.A.T.E. scores: a novel predictive tool for the risk of positive surgical margin after radical prostatectomy

Zeitschrift:
Journal of Cancer Research and Clinical Oncology > Ausgabe 4/2017
Autoren:
Ben Xu, Cheng Luo, Qian Zhang, Jie Jin
Wichtige Hinweise
Ben Xu and Cheng Luo have contributed equally to this work.

Abstract

Objectives

To propose a novel scoring system to predict the risk of positive surgical margin (PSM) after radical prostatectomy (RP) in prostate cancer (PCa) patients.

Materials and methods

Eight reproducible variables available from preoperative characteristics of PCa patients were measured: PSA level (P), ratio of positive biopsy needles (R), obesity (O), scores of Gleason (S), T stage by preoperative MRI scan (T), age (A), tumor volume (T) and experience of the surgeon (E). Of the eight components, seven were scored on a 0-, 1- or 2-point scale, with only the “A” component on a 0- or 1-point scale. The P.R.O.S.T.A.T.E. scores can range from 0 to 15.

Results

A total of 441 patients were included from the Peking University First Hospital between November 2007 and March 2016, among whom 195 patients (44.2%) had a PSM identified by a postoperative pathological examination. The preoperative P.R.O.S.T.A.T.E. scores statistically correlated with the postoperative SM status (p < 0.001) when the 441 consecutive patients were divided into three groups (low-risk group: score of 0–4, moderate-risk group: score of 5–9 and high-risk group: score of 10–15). The risk of PSM after RP in the low-risk, moderate-risk and high-risk groups was 21.1, 40.1 and 87.0%, respectively.

Conclusions

The novel scoring system of P.R.O.S.T.A.T.E. that we presented was found to predict the risk of PSM after RP. A combination of reproducible, standardized parameters obtained from preoperative characteristics of PCa patients can be used as a tool for predicting PSM, thus assisting in the strategy of performing surgical procedures. More careful manipulation or wider resection may be of utmost importance in the high-risk group.

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