MP47-16 CURRENT DELAYS FROM BIOPSY TO RADICAL PROSTATECTOMY DO NOT APPEAR TO AFFECT PATHOLOGIC OUTCOMES IN LOW, INTERMEDIATE, OR HIGH-RISK DISEASE
Bibliographic record
Abstract
You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy IV1 Apr 2017MP47-16 CURRENT DELAYS FROM BIOPSY TO RADICAL PROSTATECTOMY DO NOT APPEAR TO AFFECT PATHOLOGIC OUTCOMES IN LOW, INTERMEDIATE, OR HIGH-RISK DISEASE PREMAL PATEL, Leanne Ross, Kiril Trpkov, and Geoffrey Gotto PREMAL PATELPREMAL PATEL More articles by this author , Leanne RossLeanne Ross More articles by this author , Kiril TrpkovKiril Trpkov More articles by this author , and Geoffrey GottoGeoffrey Gotto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1476AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There is a small volume of varied literature reporting on the impact of time between prostate cancer diagnosis on biopsy and definitive intervention with radical prostatectomy with regards to adverse pathological outcomes. There are considerable, and in some cases increasing, delays in treatment for patients with prostate cancer in Canada's publicly funded healthcare system. We sought to evaluate our institutional outcomes using a large multi-surgeon database. METHODS We retrospectively reviewed 2,728 patients who underwent radical prostatectomy between 2005 and 2014. Patients were stratified according to biopsy Grade Groups and pre-operative PSA levels. Pathologic outcomes were evaluated for patients with <2 months between biopsy and surgery and then at monthly intervals of up to 6 months. Adverse pathological outcomes were defined as Gleason upgrading from biopsy, the presence of extracapsular extension (pT3a) or seminal vesicle invasion (pT3b), positive surgical margins and positive lymph node involvement. The x2 test was used for statistical analysis. RESULTS In total 2310 patients met our inclusion criteria. Median time from biopsy to surgery was 83 days (range: 61-109). Grade groups 1, 2, 3, 4, 5 comprised of 906 (39.2%), 1,048 (45.4%), 231 (10%), 69 (3%) and 56 (2.4%), respectively. In total 31.8% of patients were upgraded by Grade Group on final surgical pathology. The overall positive surgical margin rates were 25% for organ confined (pT2) disease and 49.8% patients with pT3 disease. Lymph node involvement was identified in 1.5% of patients. There was no observed difference in adverse pathologic outcomes for patients in any risk category with delays of up to 6 months between biopsy and radical prostatectomy. CONCLUSIONS Surgical delays of up to 6 months following prostate biopsy were not associated with an increased risk of Gleason score upgrading, extracapsular extension, seminal vesicle invasion, positive surgical margins, or lymph node involvement. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e634-e635 Advertisement Copyright & Permissions© 2017MetricsAuthor Information PREMAL PATEL More articles by this author Leanne Ross More articles by this author Kiril Trpkov More articles by this author Geoffrey Gotto 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 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 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".