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Related Experiment Video

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An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
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Immediate Postoperative cfDNA Elevation Predicts Pain After Robot-Assisted Radical Prostatectomy.

Noritaka Ishii1, Tohru Yoneyama2, Satoko Minakawa3,4

  • 1Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.

International Journal of Urology : Official Journal of the Japanese Urological Association
|November 21, 2025
PubMed
Summary

Immediate postoperative cell-free DNA (cfDNA) levels effectively predict pain severity after robot-assisted radical prostatectomy. This biomarker may enable personalized pain management strategies for patients undergoing surgery.

Keywords:
NRSRARPbiomarkercfDNApostoperative painprostate cancer

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Area of Science:

  • Urology
  • Oncology
  • Biochemistry

Background:

  • Cell-free DNA (cfDNA) shows potential as a biomarker for surgical invasiveness.
  • The predictive value of cfDNA for postoperative outcomes, particularly pain, requires further investigation.

Purpose of the Study:

  • To evaluate if cfDNA levels measured immediately after robot-assisted radical prostatectomy (RARP) can predict postoperative pain and surgical stress.
  • To compare cfDNA with conventional markers for pain prediction.

Main Methods:

  • Retrospective analysis of 80 RARP patients.
  • Measurement of cfDNA preoperatively and immediately postoperatively.
  • Assessment of postoperative pain using the Numerical Rating Scale (NRS) and correlation with cfDNA levels and conventional stress markers.

Main Results:

  • A higher cfDNA ratio was observed in patients with moderate-to-severe pain (NRS ≥ 4).
  • Elevated cfDNA (≥ 2.00) was associated with increased odds of moderate-to-severe postoperative pain.
  • Conventional markers like CRP and WBC count did not correlate with pain severity or cfDNA levels.

Conclusions:

  • Immediate postoperative cfDNA is a sensitive biomarker for predicting pain severity after RARP.
  • The cfDNA ratio may aid in developing personalized perioperative pain management.
  • Prospective validation of these findings is recommended.