Determinants of oncologic outcomes in high‐grade organ‐confined prostate cancer after prostatectomy
Bibliographic record
Abstract
AIMS: In radical prostatectomy (RP), Grade Group (GG) 4/5 prostate cancer [high-grade prostate cancer (HGPC) hereafter] is often associated with extension beyond the prostate and positive surgical margins. Hence, there is limited information on post-RP outcomes of patients with completely resected HGPC confined to the prostate (pT2). MATERIALS AND METHODS: Clinical outcomes were assessed in a cohort of patients with pT2 HGPC and negative surgical margins using Kaplan-Meier statistics and Cox regression analysis. RESULTS AND CONCLUSION: Four hundred and seven RPs were initially assessed: 236 (58%) with GG 4 and 171 (42%) with GG 5 prostate cancer (PCa). Survival analysis was performed on subsets of patients with available follow-up (BCR: n = 343, metastases: n = 347) to identify clinicopathologic variables associated with the risk of biochemical recurrence and metastasis. The size of the dominant nodule (cut-off 15 mm) (HR 1.654, 95% CI 1.026-2.667; P = 0.04) and the preoperative PSA level (HR 1.052, 95% CI 1.009-1.097; P = 0.02) were associated with a higher likelihood of BCR on univariate regression analysis, with only preoperative PSA remaining significant when both variables were assessed concurrently (HR 1.051, 95% CI 1.007-1.098; P = 0.02). On univariate Cox regression analysis, the size of the dominant nodule (cut-off: 15 mm; HR 6.315, 95% CI 2.021-19.725; P < 0.01), the presence of large cribriform components (HR 4.375, 95% CI 0.999-19.159; P = 0.05), and LVI (HR 3.808, 95% CI 1.086-13.354; P = 0.04) were associated with the risk of metastasis, but only size remained an independent predictor on multivariate analysis (HR 5.66, 95% CI 1.761-18.191; P < 0.01In p for cut-off of 15 mm).
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".