ArticleBMC cancer2026
Development and validation of a preoperative grading system incorporating MRI and clinicopathological features to predict positive surgical margins in robot-assisted laparoscopic prostatectomy.
Article in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo develop a grading system integrating MRI and clinicopathological features for predicting positive surgical margin (PSM) following robotic-assisted laparoscopic prostatectomy (RALP) among patients with prostate cancer.
methodsPatients undergoing RALP were retrospectively included with consecutive MRI examinations collected from two centers (center 1 and center 2). The train cohort included patients at center 1 between January 2020 and December 2021, and the validation cohort comprised those between January 2022 and December 2022. Patients from center 2 were assigned to the test cohort. MRI and clinicopathological features associated with PSM were assessed. A logistic regression model was used to develop the grading system. The prediction and calibration performance were evaluated by area under the receiver operating characteristic curves (AUCs) and Hosmer-Lemeshow goodness-of-fit test. AUC values were compared by Delong test.
resultsA total of 396 patients and 29.2% (64/219), 37.6% (26/69) and 38.0% (41/108) of patients in the train, validation and test cohorts exhibited PSMs, respectively. The grading system comprised clinical risk stratification (ESMO-risk) and MRI features. The PSM grading system demonstrated good prediction performance (AUC 0.79, 95% CI: 0.70, 0.86) and showed good calibration (P = 0.82) in the test cohorts. When compared with ESMO-risk (AUC: 0.70, 95% CI: 0.60, 0.78), Park’s model (AUC: 0.72, 95% CI: 0.63, 0.81) and Xu’s model (AUC: 0.70, 95% CI: 0.60, 0.78) in the test cohort, our PSM grading system demonstrated higher AUC value (P < 0.05).
conclusionThe PSM grading system integrating MRI and clinicopathological features can assess the likelihood of PSM after RALP.
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