Personalized 3D models for prostate cancer surgery

Abstract

Nerve-sparing surgery is the standard approach used in radical prostatectomy to enhance functional outcomes, but secondary resection might be needed in case of uncertainty regarding the complete removal of the tumour. However, direct visual guidance for resecting positive surgical margins (PSMs) during secondary resection is lacking.

In a study published in BJU International, a 3D-printed prostate model was used to improve surgical precision of targeted secondary resection during nerve-sparing robot-assisted radical prostatectomy. Overall, 100 patients undergoing nerve-sparing robot-assisted radical prostatectomy were enrolled in this prospective, multicentre study. 3D models were derived from pelvic MRI to guide intraoperative secondary resection of PSMs. This approach led to a successful conversion of PSMs to negative surgical margins in 83% of patients, 95% of whom achieved undetectable PSA levels postoperatively. These results indicate that PSMs marked on a 3D model by the pathologist can improve communication between the pathologist and surgeon, ultimately improving accuracy of the secondary resection site identification. The authors acknowledged some limitations of this study, including the lack of a control group, but concluded that the integration of personalized 3D models in surgical practice could substantially optimize precision in prostate cancer secondary resection.