We evaluated contemporary trends in radical prostatectomy(RP)in men aged>70 years and investigated associations of selected variables with recovery of urinary continence(UC)in two age groups:>70 and<70 years....We evaluated contemporary trends in radical prostatectomy(RP)in men aged>70 years and investigated associations of selected variables with recovery of urinary continence(UC)in two age groups:>70 and<70 years.A retrospective cohort of 2301 eligible patients attending our institution from 2004 to 2015 was reviewed.Patients were divided into two groups based on age at surgery(>70 years[n=610]vs<70 years[n=1691])and four groups by year of surgery.Over the study period,the proportion of patients aged>70 years gradually increased up to 30.0%,and the rate of robot-assisted RP and neurovascular bundle(NVB)saving increased continually to 80.0%and 67.4%of older patients,respectively.Although the rate of recovery of UC within 12 months(3 months)in patients aged>70 years was lower than that in those aged S70 years(81.5%[52.6%]vs 88.6%[60.9%],respectively;both P<0.001),the gap between age groups in the rate of recovery within 12 mon ths n arrowed from the sec ond quarter of the study period.Among youn ger patie nts,age,robot-assisted RP,prostate volume,membra nous urethral length(MUL),and NVB savi ng were predictors of recovery of UC within 3 or 12 months.In contrast,only age and MUL were predictors of recovery of UC within 3 and 12 months in patients aged>70 years.Therefore,unlike younger patients,only variables(age and MUL),possibly associated with the inhere nt fun ction of the urinary sphi ncter,were predictors of recovery of UC in patients aged>70 years.展开更多
The aim of this study was to determine whether the neutrophil-to-lymphocyte ratio （NLR）, a measure of the systemic inflammatory response is associated with the overall prostate cancer detection rate in men who under...The aim of this study was to determine whether the neutrophil-to-lymphocyte ratio （NLR）, a measure of the systemic inflammatory response is associated with the overall prostate cancer detection rate in men who underwent contemporary multi （〉12）-core transrectal ultrasound （TRUS） biopsy. We reviewed the records of 3913 patients with initial prostate-specific antigen （PSA） levels ranging from 4 to 10 ng ml^-1 who underwent TRUS-guided prostate biopsy between April 2006 and May 2014. NLR was calculated by prebiopsy neutrophil and lymphocyte counts. We excluded patients who had evidence of acute prostatitis, a history of prostate surgery, and any systemic inflammatory disease. A multivariate logistic regression model was used to analyze prostate cancer detection. After adjusting for confounding factors, predictive values were determined according to the receiver operating characteristic-derived area under the curve, both including and excluding the NLR variable. In univariate analyses, NLR was a significant predictor of prostate cancer detection （P 〈 0.001）. In multivariate analyses, a higher NLR was significantly associated with prostate cancer detection after adjusting for other factors （OR = 1.372, P = 0.038）. The addition of NLR increased the accuracy from 0.712 to 0,725 （P = 0.005） in the multivariate model for prostate cancer detection. NLR may be a potentially useful clinical marker in the detection of prostate cancer among men with a PSA level in the 4-10 ng ml^-1 range. These findings are derived from a retrospective analysis and should be validated in larger populations through prospective studies.展开更多
We aimed to develop and validate a clinical nomogram predicting bladder outlet obstruction(BOO)solely using routine clinical parameters in men with refractory nonneurogenic lower urinary tract symptoms(LUTS).A total o...We aimed to develop and validate a clinical nomogram predicting bladder outlet obstruction(BOO)solely using routine clinical parameters in men with refractory nonneurogenic lower urinary tract symptoms(LUTS).A total of 750 eligible patient ≥50 years of age who had previously not responded(International Prostate Symptom Score[IPSS]improvement<4 points)to at least three different kinds of LUTS medications(including a-blocker)for the last 6 months were evaluated as subcohorts for nomogram development(n=570)and for split-sample validation(n=180).BOO was defined as Abrams-Griffiths number^40,or 20-39.9 with a slope of linear passive urethral resistance ratio>2 cmH20 ml^-1 s^-1.A stepwise multivariable logistic regression analysis was conducted to determine the predictors of BOO,and^-coefficients of the final model were selected to create a clinical nomogram.The final multivariable logistic regression model showed that age,IPSS,maximum urinary flow rate,postvoid residual volume,total prostate volume,and transitional zone index were significant for predicting BOO;these candidates were used to develop the final nomogram.The discrimination performance of the nomogram was 88.3%(95%Cl:82.7%-93.0%,P<0.001),and the nomogram was reasonably we 11-fitted to the ideal line of the calibration plot.Independe nt split-sample validation revealed 80.9%(95%Cl:75.5%-84.4%,P<0.001)accuracy.The proposed BOO nomogram based solely on routine clinical parameters was accurate and validated properly.This nomogram may be useful in determining further treatment,primarily focused on prostatic surgery for BOO,without impeding the detection of possible BOO in men with LUTS that is refractory to empirical medications.展开更多
We evaluated whether the prostate-specific antigen (PSA)mass or free PSA (fPSA)mass (i.e.,absolute amount of total circulating PSA or fPSA protein,respectively),versus serum PSA or fPSA concentration,improves the accu...We evaluated whether the prostate-specific antigen (PSA)mass or free PSA (fPSA)mass (i.e.,absolute amount of total circulating PSA or fPSA protein,respectively),versus serum PSA or fPSA concentration,improves the accuracy of predicting the total prostate volume (TPV)in relation to obesity.Among men whose multicore (≥12)transrectal prostate biopsy was negative,586 who had a PSA of <10 ng ml^-1 and underwent the fPSA test prior to biopsy were enrolled.The PSA mass or fPSA mass (pg)was calculated by multiplying the serum level by plasma volume.At each TPV cut-off point (30 ml,40 ml,and 50 ml),the areas under the receiver operating characteristics curve (AUCs)of each variable were compared in obesity-based subgroups.AUCs of fPSA and fPSA mass for predicting TPV were significantly larger than those for PSA and PSA mass by 8.7%-12.1%at all cut-off points. Subgroup analyses based on obesity showed that,although PSA mass and fPSA mass enhanced accuracy by 4%(P =0.031)and 1.8%(P =0.003),respectively,for determining TPVs of ≥30 ml and ≥50 ml in obese and overweight men,they did not improve the accuracy in most other combinations of the degrees of obesity with TPV cut-off points.Thus,compared with serum PSA or fPSA,the absolute amount of PSA or fPSA protein mass improved the accuracy of predicting TPV in obese men very minimally and only for certain TPV cut-off points.Hence,these indicators may not provide clinically meaningful improvement in predicting TPV in obese men.展开更多
Erratum to Nano Research 2020,13(12):3338-3346 htts://doi.org/00.1007/s12274-020-3014-3 One author name and corresponding affiliation of the original version of this article were unfortunately mislabeled.
文摘We evaluated contemporary trends in radical prostatectomy(RP)in men aged>70 years and investigated associations of selected variables with recovery of urinary continence(UC)in two age groups:>70 and<70 years.A retrospective cohort of 2301 eligible patients attending our institution from 2004 to 2015 was reviewed.Patients were divided into two groups based on age at surgery(>70 years[n=610]vs<70 years[n=1691])and four groups by year of surgery.Over the study period,the proportion of patients aged>70 years gradually increased up to 30.0%,and the rate of robot-assisted RP and neurovascular bundle(NVB)saving increased continually to 80.0%and 67.4%of older patients,respectively.Although the rate of recovery of UC within 12 months(3 months)in patients aged>70 years was lower than that in those aged S70 years(81.5%[52.6%]vs 88.6%[60.9%],respectively;both P<0.001),the gap between age groups in the rate of recovery within 12 mon ths n arrowed from the sec ond quarter of the study period.Among youn ger patie nts,age,robot-assisted RP,prostate volume,membra nous urethral length(MUL),and NVB savi ng were predictors of recovery of UC within 3 or 12 months.In contrast,only age and MUL were predictors of recovery of UC within 3 and 12 months in patients aged>70 years.Therefore,unlike younger patients,only variables(age and MUL),possibly associated with the inhere nt fun ction of the urinary sphi ncter,were predictors of recovery of UC in patients aged>70 years.
文摘The aim of this study was to determine whether the neutrophil-to-lymphocyte ratio （NLR）, a measure of the systemic inflammatory response is associated with the overall prostate cancer detection rate in men who underwent contemporary multi （〉12）-core transrectal ultrasound （TRUS） biopsy. We reviewed the records of 3913 patients with initial prostate-specific antigen （PSA） levels ranging from 4 to 10 ng ml^-1 who underwent TRUS-guided prostate biopsy between April 2006 and May 2014. NLR was calculated by prebiopsy neutrophil and lymphocyte counts. We excluded patients who had evidence of acute prostatitis, a history of prostate surgery, and any systemic inflammatory disease. A multivariate logistic regression model was used to analyze prostate cancer detection. After adjusting for confounding factors, predictive values were determined according to the receiver operating characteristic-derived area under the curve, both including and excluding the NLR variable. In univariate analyses, NLR was a significant predictor of prostate cancer detection （P 〈 0.001）. In multivariate analyses, a higher NLR was significantly associated with prostate cancer detection after adjusting for other factors （OR = 1.372, P = 0.038）. The addition of NLR increased the accuracy from 0.712 to 0,725 （P = 0.005） in the multivariate model for prostate cancer detection. NLR may be a potentially useful clinical marker in the detection of prostate cancer among men with a PSA level in the 4-10 ng ml^-1 range. These findings are derived from a retrospective analysis and should be validated in larger populations through prospective studies.
文摘We aimed to develop and validate a clinical nomogram predicting bladder outlet obstruction(BOO)solely using routine clinical parameters in men with refractory nonneurogenic lower urinary tract symptoms(LUTS).A total of 750 eligible patient ≥50 years of age who had previously not responded(International Prostate Symptom Score[IPSS]improvement<4 points)to at least three different kinds of LUTS medications(including a-blocker)for the last 6 months were evaluated as subcohorts for nomogram development(n=570)and for split-sample validation(n=180).BOO was defined as Abrams-Griffiths number^40,or 20-39.9 with a slope of linear passive urethral resistance ratio>2 cmH20 ml^-1 s^-1.A stepwise multivariable logistic regression analysis was conducted to determine the predictors of BOO,and^-coefficients of the final model were selected to create a clinical nomogram.The final multivariable logistic regression model showed that age,IPSS,maximum urinary flow rate,postvoid residual volume,total prostate volume,and transitional zone index were significant for predicting BOO;these candidates were used to develop the final nomogram.The discrimination performance of the nomogram was 88.3%(95%Cl:82.7%-93.0%,P<0.001),and the nomogram was reasonably we 11-fitted to the ideal line of the calibration plot.Independe nt split-sample validation revealed 80.9%(95%Cl:75.5%-84.4%,P<0.001)accuracy.The proposed BOO nomogram based solely on routine clinical parameters was accurate and validated properly.This nomogram may be useful in determining further treatment,primarily focused on prostatic surgery for BOO,without impeding the detection of possible BOO in men with LUTS that is refractory to empirical medications.
文摘We evaluated whether the prostate-specific antigen (PSA)mass or free PSA (fPSA)mass (i.e.,absolute amount of total circulating PSA or fPSA protein,respectively),versus serum PSA or fPSA concentration,improves the accuracy of predicting the total prostate volume (TPV)in relation to obesity.Among men whose multicore (≥12)transrectal prostate biopsy was negative,586 who had a PSA of <10 ng ml^-1 and underwent the fPSA test prior to biopsy were enrolled.The PSA mass or fPSA mass (pg)was calculated by multiplying the serum level by plasma volume.At each TPV cut-off point (30 ml,40 ml,and 50 ml),the areas under the receiver operating characteristics curve (AUCs)of each variable were compared in obesity-based subgroups.AUCs of fPSA and fPSA mass for predicting TPV were significantly larger than those for PSA and PSA mass by 8.7%-12.1%at all cut-off points. Subgroup analyses based on obesity showed that,although PSA mass and fPSA mass enhanced accuracy by 4%(P =0.031)and 1.8%(P =0.003),respectively,for determining TPVs of ≥30 ml and ≥50 ml in obese and overweight men,they did not improve the accuracy in most other combinations of the degrees of obesity with TPV cut-off points.Thus,compared with serum PSA or fPSA,the absolute amount of PSA or fPSA protein mass improved the accuracy of predicting TPV in obese men very minimally and only for certain TPV cut-off points.Hence,these indicators may not provide clinically meaningful improvement in predicting TPV in obese men.
文摘Erratum to Nano Research 2020,13(12):3338-3346 htts://doi.org/00.1007/s12274-020-3014-3 One author name and corresponding affiliation of the original version of this article were unfortunately mislabeled.
