Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Università Politecnica delle Marche, Ancona, Italy.
Department of Urology, Azienda Ospedaliero-Universitaria di Modena e reggio Emilia, Baggiovara, Italy.
Chin Clin Oncol. 2024 Aug;13(4):54. doi: 10.21037/cco-24-52.
Robotic-assisted radical prostatectomy (RARP) is currently a first-line treatment option for men with localized prostate cancer (PCa), at least 10 years of life expectancy, and candidate for curative treatment. We performed a scoping review to evaluate the role of artificial intelligence (AI) on RARP for PCa.
A comprehensive literature search was performed using EMBASE, PubMed, and Scopus. Only English papers were accepted. The PICOS (Patient Intervention Comparison Outcome Study type) model was used; P: adult men with PCa undergoing RARP; I: use of AI; C: none; O: preoperative planning improvement and postoperative outcomes; S: prospective and retrospective studies.
Seventeen papers were included, dealing with prediction of positive surgical margins/extraprostatic extension, biochemical recurrence, patient's outcomes, intraoperative superimposition of magnetic resonance images to identify and locate lesions for nerve-sparing surgery, identification and labeling of surgical steps, and quality of surgery. All studies found improving outcomes in procedures employing AI.
The integration of AI in RARP represents a transformative advancement in surgical practice, augmenting surgical precision, enhancing decision-making processes and facilitating personalized patient care. This holds immense potential to improve surgical outcomes and teaching, and mitigate complications. This should be balanced against the current costs of implementation of robotic platforms with such a technology.
机器人辅助根治性前列腺切除术(RARP)目前是局限性前列腺癌(PCa)患者的一线治疗选择,这些患者预期寿命至少 10 年,且适合进行治愈性治疗。我们进行了一项范围性综述,以评估人工智能(AI)在 PCa 的 RARP 中的作用。
我们使用 EMBASE、PubMed 和 Scopus 进行了全面的文献检索。仅接受英文论文。使用 PICOS(患者干预比较结局研究类型)模型;P:接受 RARP 的患有 PCa 的成年男性;I:使用 AI;C:无;O:术前规划改进和术后结果;S:前瞻性和回顾性研究。
共纳入了 17 篇论文,涉及预测阳性手术切缘/前列腺外延伸、生化复发、患者结局、术中磁共振图像叠加以识别和定位神经保留手术中的病变、识别和标记手术步骤以及手术质量。所有研究都发现,在采用 AI 的手术中,结果得到了改善。
将 AI 融入 RARP 代表了手术实践的变革性进展,增强了手术精度,改善了决策过程,并促进了个性化的患者护理。这具有极大的潜力来改善手术结果和教学,并减轻并发症。在实施具有此类技术的机器人平台时,应权衡当前的成本。