Analysis Of Related Factors And Risk Prediction Of Positive Margin After Radical Prostatectomy

Objective:By analyzing the risk factors associated with positive margins after radical prostatectomy,we explored a scoring system for positive margins after radical prostatectomy.To explore the clinical significance of this scoring system for predicting the margin of prostate cancer after radical surgery,and to help the diagnosis and treatment of clinical work.Methods:To collect and retrospectively analyze the clinical data of patients with prostate cancer treated by the First Affiliated Hospital of Nanchang University from January2011 to October 2018.According to the postoperative pathological margin,the patients were divided into positive margin and negative margin.The age,prostate volume,serum prostate specific antigen(PSA),and percentage of positive cores,Clinical stage,Surgical approach,perineural invasion in biopsy(PNIb)were compared.;Univariate analysis of the above factors,and then the meaningful factors were further analyzed by multivariate logistic regression.Analysis of risk factors for positive margins.A score scale was established based on the relevant factors,and applied to 50 patients from October 20 to 2019 in March 2018 to verify the feasibility of the scoring system and predict the risk of positive margin after radical prostatectomy..Results:Univariate analysis showed that PSA,percentage of positive cores,clinical stage,Surgical approach,Gleason score and perineural invasion in biopsy were significantly associated with positive margin of margin(P<0.05),PSA,perineural invasion in biopsy,Gleason score and percentage of positive cores are independent risk factor for positive surgical margins in the multivariate logistic regression.Each parameter assignment score is as follows: perineural invasion(with = 2 points,no = 1 point), PSA(<10ng/ml = 1 point,10-20ng/ml = 2 points,> 20ng/ml = 4 points),Gleason score(<6=1 point,7= 2 points,?8 = 4 points)and puncture positive Percentage of needles(<25%= 1 point,25-49% =2 points,? 50% = 4 points).For diagnosis scoring system,the area under the ROC curve was 0.789(0.730-0.849)and the standard error was 0.030.the risk score cut-off points was 6.Conclusion:1.PNIb,percentage of positive cores,Gleason score and serum PSA are independent risk factors for positive margin.2.The risk score cut-off points of the scoring system was 7.When the risk score is?6points,the scope of surgical resection should be expanded as much as possible.For the total score <6 points,radical prostatectomy with preserved nerve can be considered.3.The scoring system had moderate efficacy in predicting the risk of positive surgical margins after radical prostatectomy.