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ORIGINAL RESEARCH article
Front. Surg.
Sec. Genitourinary Surgery and Interventions
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1563344
This article is part of the Research Topic Advances in Medical Imaging for Precision Diagnostic and Therapeutic Applications in Digestive Diseases View all 5 articles
Enhanced Precision in Prostate Surgery: Determining Key Factors for Rectal Positive Surgical Margins through Integrated Imaging and Clinical Data Analysis
Provisionally accepted
Yufan Wu 1*
Fei Liu 2
Shiyu Ma 3
Guodong Jing 3 Qiwei Yu 4 Chengwei Shao 3* Linya Yao 4* Xingbo Wang 5*- 1 Soochow University, Suzhou, China
- 2 Kunshan Sixth People's Hospital, Kunshan, China
- 3 Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China
- 4 Kunshan Traditional Chinese Medicine Hospital, Kunshan, Jiangsu Province, China
- 5 Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China
Objective: This study investigates the risk factors associated with rectal positive surgical margins (RPSM) following radical prostatectomy and aims to develop a predictive model. Methods: Clinical data from 198 patients undergoing radical prostatectomy at the Department of Urology, Kunshan Hospital of Traditional Chinese Medicine from June 2022 to June 2024 were analyzed. Patients were categorized into groups with and without RPSM. Univariate and multivariate logistic regression analyses identified independent predictors of RPSM. Utilizing R software, we generated a column chart illustrating prostate cancer's RPSM incidence and constructed ROC curves with the area under the curve (AUC) to assess the discriminative performance and calibration of our model. Results: Multivariate logistic regression identified clinical stage, PSA level, Gleason score, bilateral prostate infiltration, and PI-RADS as significant predictors of RPSM (all P<0.05). Using these predictors, we developed a nomogram that achieved a C-index of 0.833(95% CI: 0.785-0.887) and an AUC of 0.755 (95% CI: 0.645–0.866). Conclusion: The predictive model effectively forecasts the likelihood of RPSM following radical prostatectomy, offering valuable insights for personalized patient management.
Keywords: prostate cancer, Radical Prostatectomy, Rectal Positive Surgical Margins, predictive model, PI-RADS
Received: 08 Feb 2025; Accepted: 24 Mar 2025.
Copyright: © 2025 Wu, Liu, Ma, Jing, Yu, Shao, Yao and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yufan Wu, Soochow University, Suzhou, China
Chengwei Shao, Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China
Linya Yao, Kunshan Traditional Chinese Medicine Hospital, Kunshan, 215300, Jiangsu Province, China
Xingbo Wang, Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China
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