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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 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) | 0.000 | 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 teacher head, 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".