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Special Issue "Prostatectomy: The Current Recommendations for Clinical Practice"

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Dear Colleagues,

Prostate cancer is the first malignancy in men, and radical prostatectomy represents the standard treatment for localized disease. In recent years, different technological and technical innovations have been developed, starting from the advent of robotic systems in the early 2000 until the lastly introduced single port platform. In parallel, new imaging modalities can help both for staging purposes and intraoperative navigation, such as the availability of real-time overlapping of 3D models in an augmented reality setting. Finally, surgical indication has also been reconsidered under the light of new technologies such as the PSMA-PET, and new horizons have been opened, such as for the treatment of oligometastatic patients. In this Special Issue, we invite authors to submit papers (clinical studies or reviews) on radical prostatectomy, including the description of surgical techniques or approaches and the introduction of new imaging modalities and new technologies.

Dr. Enrico Checcucci
Prof. Dr. Francesco Porpiglia
Guest Editors

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Keywords

prostate cancer
robotics
single port
augmented reality
confocal microscopy

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Research

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Open AccessArticle

Machine-Learning-Based Tool to Predict Target Prostate Biopsy Outcomes: An Internal Validation Study

and

J. Clin. Med. 2023, 12(13), 4358; https://doi.org/10.3390/jcm12134358 - 28 Jun 2023

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Abstract

The aim of this study is to present a personalized predictive model (PPM) with a machine learning (ML) system that is able to identify and classify patients with suspected prostate cancer (PCa) following mpMRI. We extracted all the patients who underwent fusion biopsy (FB) from March 2014 to December 2019, while patients from August 2020 to April 2021 were included as a validation set. The proposed system was based on the following four ML methods: a fuzzy inference system (FIS), the support vector machine (SVM), k-nearest neighbors (KNN), and self-organizing maps (SOMs). Then, a system based on fuzzy logic (FL) + SVM was compared with logistic regression (LR) and standard diagnostic tools. A total of 1448 patients were included in the training set, while 181 patients were included in the validation set. The area under the curve (AUC) of the proposed FIS + SVM model was comparable with the LR model but outperformed the other diagnostic tools. The FIS + SVM model demonstrated the best performance, in terms of negative predictive value (NPV), on the training set (78.5%); moreover, it outperformed the LR in terms of specificity (92.1% vs. 83%). Considering the validation set, our model outperformed the other methods in terms of NPV (60.7%), sensitivity (90.8%), and accuracy (69.1%). In conclusion, we successfully developed and validated a PPM tool using the FIS + SVM model to calculate the probability of PCa prior to a prostate FB, avoiding useless ones in 15% of the cases. Full article

(This article belongs to the Special Issue Prostatectomy: The Current Recommendations for Clinical Practice)

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Review

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Open AccessReview

A Systematic Review of New Imaging Technologies for Robotic Prostatectomy: From Molecular Imaging to Augmented Reality

Severin Rodler

Marc Anwar Kidess

Thilo Westhofen

Karl-Friedrich Kowalewski

Ines Rivero Belenchon

Christian Georg Stief

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Giovanni Enrico Cacciamani

J. Clin. Med. 2023, 12(16), 5425; https://doi.org/10.3390/jcm12165425 - 21 Aug 2023

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Abstract

New imaging technologies play a pivotal role in the current management of patients with prostate cancer. Robotic assisted radical prostatectomy (RARP) is a standard of care for localized disease and through the already imaging-based console subject of research towards combinations of imaging technologies and RARP as well as their impact on surgical outcomes. Therefore, we aimed to provide a comprehensive analysis of the currently available literature for new imaging technologies for RARP. On 24 January 2023, we performed a systematic review of the current literature on Pubmed, Scopus and Web of Science according to the PRISMA guidelines and Oxford levels of evidence. A total of 46 studies were identified of which 19 studies focus on imaging of the primary tumor, 12 studies on the intraoperative tumor detection of lymph nodes and 15 studies on the training of surgeons. While the feasibility of combined approaches using new imaging technologies including MRI, PSMA-PET CT or intraoperatively applied radioactive and fluorescent dyes has been demonstrated, the prospective confirmation of improvements in surgical outcomes is currently ongoing. Full article

(This article belongs to the Special Issue Prostatectomy: The Current Recommendations for Clinical Practice)

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Special Issue "Prostatectomy: The Current Recommendations for Clinical Practice"

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