Development and validation of nomograms for predicting pentafecta outcomes before and after robot-assisted radical prostatectomy: a retrospective study
Abstract Prostate cancer (PCa) is one of the most common cancers among men worldwide, and robot-assisted radical prostatectomy (RARP) is a widely used treatment for localized PCa. Achieving pentafecta outcomes, which include continence, potency, cancer control, free surgical margins, and no major co...
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Nature Portfolio
2025-01-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-86120-w |
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| author | Tanan Bejrananda Kiyoshi Takahara Dutsadee Sowanthip Tomonari Motonaga Kota Yagi Wataru Nakamura Masanobu Saruta Takuhisa Nukaya Masashi Takenaka Kenji Zennami Manabu Ichino Hitomi Sasaki Makoto Sumitomo Ryoichi Shiroki |
| author_facet | Tanan Bejrananda Kiyoshi Takahara Dutsadee Sowanthip Tomonari Motonaga Kota Yagi Wataru Nakamura Masanobu Saruta Takuhisa Nukaya Masashi Takenaka Kenji Zennami Manabu Ichino Hitomi Sasaki Makoto Sumitomo Ryoichi Shiroki |
| author_sort | Tanan Bejrananda |
| collection | DOAJ |
| description | Abstract Prostate cancer (PCa) is one of the most common cancers among men worldwide, and robot-assisted radical prostatectomy (RARP) is a widely used treatment for localized PCa. Achieving pentafecta outcomes, which include continence, potency, cancer control, free surgical margins, and no major complications, is a critical measure of surgical success and long-term prognosis. However, predicting these outcomes remains challenging. In this retrospective, single-center study, we analyzed data from 1,752 patients who underwent RARP for localized prostate adenocarcinoma between August 2009 and April 2023. The pentafecta outcome was achieved in 290 patients (16.6%). Multivariate analysis revealed that bilateral nerve sparing significantly increased the likelihood of achieving the pentafecta outcome (odds ratio 10.36, 95% CI: 5.75–18.66; p < 0.001). Preoperative potency and bilateral nerve sparing were also identified as key predictors. Nomograms were developed using preoperative and postoperative variables, including age, PSA level, biopsy Gleason score, clinical stage, pathological tumor stage, tumor grade, nerve sparing, and preoperative potency. Internal validation of the nomograms was performed using bootstrapping methods, demonstrating robust predictive performance. These nomograms provide valuable tools for personalized surgical planning and patient counseling and may be applicable to broader populations, given the inclusion of universally recognized predictive factors and rigorous validation. This study presents the development and validation of nomograms to predict pentafecta outcomes before and after RARP. These nomograms provide valuable tools for clinicians to estimate the likelihood of achieving postoperative pentafecta outcomes. Incorporating these nomograms into clinical practice may improve patient counseling and shared decision-making. |
| format | Article |
| id | doaj-art-6a5d2b2b68d84d1bbe8451bedacb1ae7 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-6a5d2b2b68d84d1bbe8451bedacb1ae72025-01-19T12:21:23ZengNature PortfolioScientific Reports2045-23222025-01-0115111310.1038/s41598-025-86120-wDevelopment and validation of nomograms for predicting pentafecta outcomes before and after robot-assisted radical prostatectomy: a retrospective studyTanan Bejrananda0Kiyoshi Takahara1Dutsadee Sowanthip2Tomonari Motonaga3Kota Yagi4Wataru Nakamura5Masanobu Saruta6Takuhisa Nukaya7Masashi Takenaka8Kenji Zennami9Manabu Ichino10Hitomi Sasaki11Makoto Sumitomo12Ryoichi Shiroki13Division of Urology, Department of Surgery, Faculty of Medicine, Prince of Songkla UniversityDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Fujita Health University School of MedicineAbstract Prostate cancer (PCa) is one of the most common cancers among men worldwide, and robot-assisted radical prostatectomy (RARP) is a widely used treatment for localized PCa. Achieving pentafecta outcomes, which include continence, potency, cancer control, free surgical margins, and no major complications, is a critical measure of surgical success and long-term prognosis. However, predicting these outcomes remains challenging. In this retrospective, single-center study, we analyzed data from 1,752 patients who underwent RARP for localized prostate adenocarcinoma between August 2009 and April 2023. The pentafecta outcome was achieved in 290 patients (16.6%). Multivariate analysis revealed that bilateral nerve sparing significantly increased the likelihood of achieving the pentafecta outcome (odds ratio 10.36, 95% CI: 5.75–18.66; p < 0.001). Preoperative potency and bilateral nerve sparing were also identified as key predictors. Nomograms were developed using preoperative and postoperative variables, including age, PSA level, biopsy Gleason score, clinical stage, pathological tumor stage, tumor grade, nerve sparing, and preoperative potency. Internal validation of the nomograms was performed using bootstrapping methods, demonstrating robust predictive performance. These nomograms provide valuable tools for personalized surgical planning and patient counseling and may be applicable to broader populations, given the inclusion of universally recognized predictive factors and rigorous validation. This study presents the development and validation of nomograms to predict pentafecta outcomes before and after RARP. These nomograms provide valuable tools for clinicians to estimate the likelihood of achieving postoperative pentafecta outcomes. Incorporating these nomograms into clinical practice may improve patient counseling and shared decision-making.https://doi.org/10.1038/s41598-025-86120-wPentafectaProstatectomyRoboticPredictionNomogramRobot-assisted radical prostatectomy |
| spellingShingle | Tanan Bejrananda Kiyoshi Takahara Dutsadee Sowanthip Tomonari Motonaga Kota Yagi Wataru Nakamura Masanobu Saruta Takuhisa Nukaya Masashi Takenaka Kenji Zennami Manabu Ichino Hitomi Sasaki Makoto Sumitomo Ryoichi Shiroki Development and validation of nomograms for predicting pentafecta outcomes before and after robot-assisted radical prostatectomy: a retrospective study Scientific Reports Pentafecta Prostatectomy Robotic Prediction Nomogram Robot-assisted radical prostatectomy |
| title | Development and validation of nomograms for predicting pentafecta outcomes before and after robot-assisted radical prostatectomy: a retrospective study |
| title_full | Development and validation of nomograms for predicting pentafecta outcomes before and after robot-assisted radical prostatectomy: a retrospective study |
| title_fullStr | Development and validation of nomograms for predicting pentafecta outcomes before and after robot-assisted radical prostatectomy: a retrospective study |
| title_full_unstemmed | Development and validation of nomograms for predicting pentafecta outcomes before and after robot-assisted radical prostatectomy: a retrospective study |
| title_short | Development and validation of nomograms for predicting pentafecta outcomes before and after robot-assisted radical prostatectomy: a retrospective study |
| title_sort | development and validation of nomograms for predicting pentafecta outcomes before and after robot assisted radical prostatectomy a retrospective study |
| topic | Pentafecta Prostatectomy Robotic Prediction Nomogram Robot-assisted radical prostatectomy |
| url | https://doi.org/10.1038/s41598-025-86120-w |
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