New surgical approaches for clinically high-risk or metastatic prostate cancer
Bibliographic record
Abstract
INTRODUCTION: A considerable number of individuals with prostate cancer (PCa) still harbor locally-advanced and metastatic disease. Although such men were initially not considered eligible for local treatment, the role of radical prostatectomy (RP) has been recently reassessed. Areas covered: This review analyses currently published evidences regarding new surgical approaches for clinically high-risk PCa individuals, as well as the role of cytoreductive surgery in the metastatic setting. The role of robot-assisted radical prostatectomy (RARP) and extended pelvic lymph node dissection will be evaluated with regards to perioperative, oncologic, as well as functional outcomes. Expert commentary: RARP is a feasible approach in PCa patients regardless of the presence of high-risk disease features and can achieve optimal short-term oncologic outcomes and acceptable short/intermediate-term functional outcomes, that are comparable to those reported for open RP. Extended pelvic lymph node dissection can be performed in this setting and should be recommended for all high-risk PCa patients. The overall rate of complications in contemporary men treated with RARP for high-risk disease is not negligible. Cytoreduction in the oligo-metastatic setting is feasible and relatively safe, although evidence is scarce to recommend its widespread adoption. In consequence, longer follow-up data and, ideally, randomized controlled trials are needed.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| 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".