Objectives: To compare racial differences and pelvis dimensions between Caucasians and African Americans (AAs) and to develop a risk calculator and scoring system to predict the risk of prolonged operative time and presence of positive surgical margins (PSM) based on these dimensions. Materials and Methods: A retrospective review of 88 consecutive patients undergoing robot-assisted laparoscopic prostatectomy with a preoperative prostate MRI conducted. Data extraction included demographic, perioperative, and postoperative oncologic outcomes. Prostate-specific antigen (PSA) was obtained within 3 months postsurgery. Wilcoxon rank sum and Fisher's exact tests were used to compare continuous and categorical data, respectively. Single and multivariable regression analysis were used to determine contribution of each factor to the composite outcomes. A risk score was created based on this analysis for predicting the composite outcome. Results: We identified 88 consecutive patients with localized prostate cancer that underwent a preoperative prostate MRI. No statistically significant differences were found with respect to age, body mass index, or any postoperative outcome. PSA was lower at diagnosis (6.49 vs 9.72, p = 0.006) and operative times were shorter in Caucasians. Rates of PSM (13 vs 14, p = 0.35), biochemical recurrence (4 vs 2, p = 0.69), and complications did not vary between the groups. Caucasians had wider/shallower pelvis dimensions. Based on these variables, we found that the log (odds of OR time >3 hours or PSM) = -5.333 + 1.158 (if AA) +0.105 × PSA +0.076 × F -0.035 × G with an area under the receiver operating characteristic curve = 0.73. Using the predefined variables, patients can be risk stratified for PSM or prolonged operative times. Conclusions: Several pelvis dimensions were found to be shorter/narrower in AAs and were associated with longer operative times. The presented risk calculator and stratification system may be used to predict prolonged operative time or having PSM.

中文翻译：

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创建一种新颖的、种族调整的、风险适应的评分系统，以预测机器人根治性前列腺切除术期间的阳性手术利润和延长的手术时间。

目的：比较白种人和非裔美国人 (AA) 之间的种族差异和骨盆尺寸，并开发风险计算器和评分系统，以根据这些尺寸预测手术时间延长和手术切缘阳性 (PSM) 存在的风险。材料和方法：对 88 名连续接受机器人辅助腹腔镜前列腺切除术的患者进行回顾性分析，并进行术前前列腺 MRI 扫描。数据提取包括人口统计、围手术期和术后肿瘤学结果。术后3个月内获得前列腺特异性抗原(PSA)。Wilcoxon 秩和和 Fisher 精确检验分别用于比较连续数据和分类数据。使用单变量和多变量回归分析来确定每个因素对综合结果的贡献。根据此分析创建风险评分以预测综合结果。结果：我们连续确定了 88 名患有局限性前列腺癌的患者，这些患者接受了术前前列腺 MRI 检查。在年龄、体重指数或任何术后结果方面没有发现统计学上的显着差异。白种人诊断时 PSA 较低（6.49 vs 9.72，p = 0.006），手术时间较短。各组之间的 PSM 发生率（13 比 14，p = 0.35）、生化复发率（4 比 2，p = 0.69）和并发症没有差异。白种人的骨盆尺寸更宽/更浅。基于这些变量，我们发现对数（OR时间> 3小时或PSM的几率）= -5.333 + 1.158（如果AA）+0.105 × PSA +0.076 × F -0.035 × G，其中接收器操作特性下的面积曲线 = 0.73。使用预定义的变量，可以对患者进行 PSM 或延长手术时间的风险分层。结论：发现 AA 中的一些骨盆尺寸更短/更窄，并且与更长的手术时间相关。所提出的风险计算器和分层系统可用于预测手术时间延长或是否进行 PSM。