When should we expect no @entity41 (pT0) once we submit incidental T1a-b XXXX to radical prostatectomy?

@entity1 @entity263 @entity66 @entity41 @entity1067 @entity1486
OBJECTIVES: To date, no tool exists to predict pT0 at radical prostatectomy (RP) in @entity1 with @entity263 (PCa) after surgery for @entity1067 (SxBPH). We aimed to fill this gap by developing a user-friendly flowchart to assist urologists when incidental PCa is diagnosed and a clinical decision is required. METHODS: We analyzed 158 T1a-T1b @entity263 @entity1 who underwent RP between 1996 and 2009. A risk stratification tool was developed applying the tree modeling technique of classification and regression tree analysis (CART) and relying on all the available pre-RP characteristics (age, @entity1486 [PSA] before SxBPH, PSA after SxBPH, cT1a-T1b stage, prostate volume and Gleason sum at SxBPH). Then, the accuracy of the proposed model using 200 bootstrap resamples for internal validation was calculated. RESULTS: A total of 95 @entity1 (60.1%) were stage T1a, and 63 (39.9%) were stage T1b. The median values of PSA before and after SxBPH were 4.2 and 1.1 ng/mL, respectively. A total of 22 @entity1 (13.9%) showed no @entity41 (pT0) at RP. The CART analyses identified three groups at risk of having @entity66 at RP: (i) PSA after SxBPH > 1.0 ng/mL (pT0 prevalence: 3.8%); (ii) PSA after SxBPH < 1.0 ng/mL and PSA before SxBPH > 2.0 ng/mL (pT0 prevalence: 14.8%); and (iii) PSA after SxBPH < 1.0 ng/mL and PSA before SxBPH < 2.0 ng/mL (pT0 prevalence: 42.3%). The accuracy of the proposed model was 77.1%. Clinical stage (T1a vs T1b) was not associated with pT0 (P = 0.4). CONCLUSIONS: Clinical stage (T1a vs T1b) assessment does not help in predicting pT0 cases. An accurate and clinically useful flowchart to predict pT0 at RP after @entity263 diagnosis is provided herein.
