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
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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.
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.
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.
KeywordsProstate Positive surgical margin Prostatectomy Predictive Scores
XB was involved in project development and manuscript writing; LC performed data collection and data analysis; ZQ performed data collection; and JJ reviewed the key points of this manuscript.
Compliance with ethical standards
Conflict of interest
There is no conflict of interest involved in this manuscript.
All authors have made a significant contribution to the findings and methods in the paper. All authors have read and approved the final draft. There are no financial interests. The work has not already been published and has not been submitted simultaneously to any other journal. The corresponding author takes on these responsibilities with his signature.
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