Department of Urology, Ankara City Hospital, Ankara, Türkiye.
Department of Radiology, Ankara City Hospital, Ankara, Türkiye.
Investig Clin Urol. 2024 Jan;65(1):53-61. doi: 10.4111/icu.20230215.
We analyzed the surgical results of patients who were treated and followed up for prostate cancer in our clinic to predict the relationship between periprostatic adipose tissue and patients with and without pathologically upstaged disease.
The study included patients who had undergone robot-assisted radical prostatectomy and preoperative multiparametric prostate magnetic resonance imaging between 18 February 2019 and 1 April 2022. The patients were divided into two groups, and the surgical and transrectal ultrasound-guided biopsy pathology results were compared according to tumor grade and distribution in 124 patients who met the selection criteria. We analyzed the relationships between upgrading/upstaging and periprostatic adipose tissue thickness (PPATT) and subcutaneous adipose tissue thickness (SATT) as measured in magnetic resonance imaging.
The median PPATT was 4.03 mm, whereas the median SATT was 36.4 mm. Upgrading was detected in 45 patients (36.3%), and upstaging was detected in 42 patients (33.9%). A receiver operating characteristic regression analysis revealed that a PPATT >3 mm was a predictive factor for upstaging after radical prostatectomy (area under curve=0.623, 95% confidence interval [CI] 0.519-0.727, p=0.025). Multivariate logistic regression analyses revealed that prostate specific antigen density ≥0.15 ng/mL/cm (odds ratio [OR] 5.054, 95% CI 2.008-12.724, p=0.001), International Society of Urological Pathology grade ≥4 (OR 9.369, 95% CI 2.109-21.626, p=0.003) and higher PPATT (OR 1.358, 95% CI 1.081-1.707, p=0.009) were independent risk factors for upstaging after radical prostatectomy.
We believe that the PPATT may be a predictive indicator for upstaging after robot-assisted laparoscopic radical prostatectomy.
我们分析了在我们诊所接受治疗和随访的前列腺癌患者的手术结果，以预测前列腺周围脂肪组织与病理分期升级/升期患者之间的关系。
本研究纳入了 2019 年 2 月 18 日至 2022 年 4 月 1 日期间接受机器人辅助根治性前列腺切除术和术前多参数前列腺磁共振成像检查的患者。根据 124 名符合选择标准的患者的肿瘤分级和分布，将患者分为两组，并比较手术和经直肠超声引导活检的病理结果。我们分析了磁共振成像测量的前列腺周围脂肪组织厚度（PPATT）和皮下脂肪组织厚度（SATT）与升级/升期之间的关系。
中位 PPATT 为 4.03mm，中位 SATT 为 36.4mm。45 例（36.3%）患者发现升级，42 例（33.9%）患者发现升期。受试者工作特征回归分析显示，PPATT＞3mm 是根治性前列腺切除术后升期的预测因素（曲线下面积=0.623，95%置信区间[CI]0.519-0.727，p=0.025）。多变量逻辑回归分析显示，前列腺特异性抗原密度≥0.15ng/mL/cm（比值比[OR]5.054，95%CI2.008-12.724，p=0.001）、国际泌尿病理学会分级≥4（OR9.369，95%CI2.109-21.626，p=0.003）和较高的 PPATT（OR1.358，95%CI1.081-1.707，p=0.009）是根治性前列腺切除术后升期的独立危险因素。
我们认为，PPATT 可能是机器人辅助腹腔镜根治性前列腺切除术后升期的预测指标。
