AUTHOR=Wu Yufan , Liu Fei , Ma Shiyu , Jing Guodong , Yu Qiwei , Yao Linya , Shao Chengwei , Chen Weiguo , Wang Xingbo 

TITLE=Enhanced precision in prostate surgery: determining key factors for rectal positive surgical margins through integrated imaging and clinical data analysis

JOURNAL=Frontiers in Surgery

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2025.1563344

DOI=10.3389/fsurg.2025.1563344

ISSN=2296-875X

ABSTRACT=ObjectiveThis study investigates the risk factors associated with rectal positive surgical margins (RPSM) following radical prostatectomy and aims to develop a predictive model.MethodsClinical data from 198 patients undergoing radical prostatectomy at the Department of Urology, Kunshan Hospital of Traditional Chinese Medicine from June 2022 to June 2024 were analyzed. Patients were categorized into groups with and without RPSM. Univariate and multivariate logistic regression analyses identified independent predictors of RPSM. Utilizing R software, we generated a column chart illustrating prostate cancer's RPSM incidence and constructed ROC curves with the area under the curve (AUC) to assess the discriminative performance and calibration of our model.ResultsMultivariate logistic regression identified clinical stage, PSA level, Gleason score, bilateral prostate infiltration, and PI-RADS as significant predictors of RPSM (all P < 0.05). Using these predictors, we developed a nomogram that achieved a C-index of 0.833(95% CI: 0.785–0.887) and an AUC of 0.755 (95% CI: 0.645–0.866).ConclusionThe predictive model effectively forecasts the likelihood of RPSM following radical prostatectomy, offering valuable insights for personalized patient management.