Analysis Of Risk Factors For Extraprostatic Extension In Clinically Localized Prostate Cancer

Objective:analyze of risk factors for extraprostatic extension(EPE)in clinically localized prostate cancer to improve the accuracy of preoperative prediction of EPE.Methods:The clinical data of 222 patients who underwent radical resection for clinically localized prostate cancer from August 2018 to November 2021 in the First Hospital of Shanxi Medical University were retrospectively analyzed.Univariate and multivariate logistic regression analysis was performed to investigate the independent risk factors affecting EPE,and receiver operating characteristic(ROC)curves were plotted to calculate and compare the performance of relevant indicators in predicting EPE.Results:The percentage of biopsy positive cores(PBPC)and prostate-specific antigen(PSA)were independent predictors of EPE,with AUC values of 0.79(95% CI: 0.73 ～ 0.84)and0.56(95% CI: 0.49 ～ 0.62),respectively,and their optimal cutoff values were 57.14%and 10.17 ng/m L,respectively.PBPC + PSA did not improve the diagnostic efficacy compared with PBPC(P>0.05).PBPC may have better power to predict EPE in patients in the non-high-risk group than in the high-risk group(P=0.03),while PSA did not differ between the two groups(P=0.14).Conclusion:PBPC and PSA improve the accuracy of preoperative prediction of extraprostatic extension in clinically localized prostate cancer,especially in non-high risk patients.PBPC and PSA cutoff values are useful in making surgical decisions whether to preserve NVB intraoperatively.