MP42-18 PATIENTS ELIGIBLE FOR ACTIVE SURVEILLANCE WHO CHOSE TO UNDERGO PROSTATECTOMY: THE DIFFERENCE BETWEEN PROSTATE CANCER FEATURES ON BIOPSY AND FINAL PATHOLOGIC REPORT
Bibliographic record
Abstract
You have accessJournal of UrologyProstate Cancer: Localized I1 Apr 2015MP42-18 PATIENTS ELIGIBLE FOR ACTIVE SURVEILLANCE WHO CHOSE TO UNDERGO PROSTATECTOMY: THE DIFFERENCE BETWEEN PROSTATE CANCER FEATURES ON BIOPSY AND FINAL PATHOLOGIC REPORT Benjamin Katz, Sue-Jean Yu, Elton Llukani, Andrew Lightfoot, Kelly Monahan, Alice McGill, and David Lee Benjamin KatzBenjamin Katz More articles by this author , Sue-Jean YuSue-Jean Yu More articles by this author , Elton LlukaniElton Llukani More articles by this author , Andrew LightfootAndrew Lightfoot More articles by this author , Kelly MonahanKelly Monahan More articles by this author , Alice McGillAlice McGill More articles by this author , and David LeeDavid Lee More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1603AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Active surveillance (AS) has become an increasing acceptable management option for men with localized prostate cancer who have low risk clinical features. Our goal was to evaluate the preoperative data in men with prostate cancer and correlate this with post prostatectomy specimens in patients who were eligible for AS but chose to undergo robotic-assisted radical prostatectomy (RARP). METHODS We performed a single-institution; single-surgeon review of 3433 patients who underwent RARP from 2005 to 2014 under an IRB approved protocol. The inclusion criteria were: PSA ≤ 10, clinical stage T1-T2a, Gleason score 6 or less on biopsy, less than 33% of cores positive and less than 50% of tumor percentage in one core. We compared preoperative data with the pathological features of prostate cancer using t-test (continuous) and chi-square test (categorical). RESULTS 2,952 patients had all data points available and of these patients, 1131 qualified for AS. Among them, 577 (51%) were found to have upgraded Gleason scores on their prostatectomy specimen. There were 552 patients upgraded to Gleason 7, 21 to Gleason 8, and 3 to Gleason 9. Only 1 patient downgraded from Gleason 6 to 5. Positive margins were found in 118 patients (10.4%), 34 of those being focally positive (3%). Pathologic stage T3 was identified in 106 patients (9.4%). Also, one patient presented with lymph node involvement on surgical pathology report. CONCLUSIONS Our study highlights an alarming percentage of men whose Gleason score was upgraded and staged following RARP. AS is an exciting and promising treatment option in the management of prostate cancer; however, appropriate education and counsel should be given to patients about the risks associated with this management style. Figure 1. Gleason score comparison from pre-operative biopsy to pathology report © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e516 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benjamin Katz More articles by this author Sue-Jean Yu More articles by this author Elton Llukani More articles by this author Andrew Lightfoot More articles by this author Kelly Monahan More articles by this author Alice McGill More articles by this author David Lee More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".