Predictive factors of incidental prostate cancer in patients undergoing surgery for presumed benign prostatic hyperplasia: an updated systematic review and meta-analysis

Frontiers in Oncology, Journal Year: 2025, Volume and Issue: 15

Published: Feb. 27, 2025

We aimed to identify the clinical predictors of incidental prostate cancer (IPCa) after surgery for presumed benign prostatic hyperplasia (BPH). The literature was comprehensively searched using PubMed, Web Science, Embase, and Cochrane databases in December 2024. used pooled standardized mean difference (SMD) odds ratio (OR) describe correlation between relevant risk factors IPCa. Twenty-one studies included 10,842 patients that were available further analysis. After BPH surgery, 957 histopathologically diagnosed with IPCa rate 8.83%. Most importantly, our results identified significantly associated age (pooled SMD = 0.36, P < 0.001), body mass index (BMI) 0.23, preoperative prostate-specific antigen (pre-PSA) 0.43, density (pre-PSAD) 0.62, 0.028), resected weight -0.22, treatment 5-alpha reductase inhibitors (5αRIs) (yes/no) OR 0.60, family history 3.81, 0.029), digital rectal examination (DRE) findings (abnormal/normal) 5.15, transrectal ultrasonography (TRUS) 2.92, 0.001). Additionally, sensitivity subgroup analyses indicated reliable robust. However, we found no significant associations volume, negative biopsy, smoking history, hypertension, diabetes, dyslipidemia, abnormal magnetic resonance imaging (all > 0.05). Age, BMI, pre-PSA, pre-PSAD, weight, 5αRIs, DRE findings, TRUS are independent predicting following surgery. Before such as age, pre-PSAD should be considered assess For high-risk patients, more detailed needle biopsy recommended before avoid missed diagnosis. In future, large-scale well-designed needed validate further. https://www.crd.york.ac.uk/prospero/, identifier CRD42025631346.

Language: Английский

Impact of Nerve-Sparing Techniques on Prostate-Specific Antigen Persistence Following Robot-Assisted Radical Prostatectomy: A Multivariable Analysis of Clinical and Pathological Predictors

Diagnostics, Journal Year: 2025, Volume and Issue: 15(8), P. 987 - 987

Published: April 13, 2025

Background/Objectives: Prostate-specific antigen (PSA) persistence, defined as a postoperative PSA level ≥ 0.1 ng/mL measured within 4-8 weeks after radical prostatectomy (RP), predicts biochemical recurrence (BCR) and adverse oncological outcomes. The influence of nerve-sparing (NS) surgical techniques on persistence remains debated, especially among patients with high-risk pathological features. This study aimed to evaluate the impact NS following robot-assisted (RARP), considering tumor characteristics, parameters, patient-specific factors. Methods: A retrospective cohort analysis was performed 779 who underwent RARP at single institution between January 2002 December 2015. inclusion criteria consisted histologically confirmed prostate cancer available preoperative data, including measurements taken surgery. served primary outcome. Statistical analyses included descriptive statistics, univariate multivariable logistic regression models identify predictors Spearman's correlation along Kruskal-Wallis H test associations. Results: Of included, 55% surgery (51% unilateral, 49% bilateral). mean 11.85 (SD: 7.63), while 0.70 4.42). An elevated associated larger size (r = 0.1285, p < 0.001), advanced stages (χ2 45.10, 3.79 × 10-9), higher Gleason scores 24.74, 1.57 10-4). correlated lower (mean: 0.20 ng/mL) compared non-NS procedures 0.65 ng/mL), slight differences unilateral 0.30 bilateral 0.35 approaches. Multivariable identified stage (coefficient 1.16, 0.04) an independent predictor had no significant effect -0.01, 0.99). Conclusions: Nerve-sparing do not independently predict when adjusting for tumor-related factors confounders. Advanced stage, particularly pT3b, primarily determines persistence. These findings highlight necessity personalized planning informed by imaging patient-centered decision making optimize functional

Language: Английский

Clinical Predictors and Risk Factors of Gleason Score Upgrade: A Retrospective Cohort Analysis

Diagnostics, Journal Year: 2025, Volume and Issue: 15(10), P. 1238 - 1238

Published: May 14, 2025

Background: In prostate cancer (PCa) patients, discrepancies between biopsy-assigned Gleason Scores and those determined from surgical specimens are frequently reported. This phenomenon, known as score upgrade (GSU), can have significant clinical implications. work aims to understand the factors contributing GSU for refining management strategies. Methods: Data 779 patients diagnosed with histologically confirmed PCa who underwent robot-assisted radical prostatectomy at a single tertiary care institution January 2005 December 2020 were examined. Results: univariable setting, 5-alpha reductase inhibitor (5-ARI) use was associated higher percentage of upgrading (42.3% vs. 30.4% among non-users; p = 0.03942). A more advanced pathological T stage (p 0.01114) lymph node positivity < 0.00001) correlated significantly GSU. logistic regression model, increased odds than twofold (OR 2.807, 0.00135). 5-ARI notably 3.809, 0.00004). Younger age slightly likelihood 0.951 per year increase in age, 0.01101). Conclusions: stage, inhibitors identified predictors

Language: Английский