PURPOSE: We investigated oncological outcomes in patients who underwent robot-assisted radical prostatectomy more than 5 years previously.
MATERIALS AND METHODS: Between June 2002 and August 2006 we prospectively followed 435 consecutive patients who underwent robot-assisted radical prostatectomy. Six patients were excluded from analysis, including 4 lost to followup and 2 with prior therapy. Biochemical recurrence was denoted as 1) adjuvant therapy or 2) 2 prostate specific antigen values above 0.2 ng/ml. Biochemical recurrence-free survival, and patient and tumor characteristics were investigated.
RESULTS: Mean ± SD patient age was 61.4 ± 7.1 years. A total of 289 patients (63%) had 5 or more years of followup and 4 (1%) were lost to followup. Median time to biochemical recurrence was 18 months (range 1 month to 9.1 years). Four patients (0.93%) died of prostate cancer. The 5-year biochemical recurrence-free survival rate was 84.9% (95% CI 81.4-88.4). Five-year biochemical recurrence-free survival was 94.4% (95% CI 91.7-97.1) for pT2 disease compared to 63.8% (95% CI 53.4-74.1) and 47.1% (95% CI 27.3-67.0) for pT3a and pT3b, respectively (p < 0.001). Patients with a Gleason score of 3 or less + 3, 3 + 4, 4 + 3 and 4 or greater + 4 experienced a 5-year biochemical recurrence-free survival of 97%, 86%, 62% and 43%, respectively (p < 0.001). Patients with positive margins had a 5-year biochemical recurrence-free survival of 60.7% (95% CI 48.7-72.7) compared to 89.6% (95% CI 86.3-92.9) in those with negative margins (p < 0.001).
CONCLUSIONS: This represents the third report of the oncological outcomes of robot-assisted radical prostatectomy, demonstrating a 5-year biochemical recurrence rate of approximately 14% and just below 1% prostate cancer specific mortality.
Written by:
Liss MA, Lusch A, Morales B, Beheshti N, Skarecky D, Narula N, Osann K, Ahlering TE. Are you the author?
Department of Urology, University of California-Irvine, Orange, California.
Reference: J Urol. 2012 Oct 18. pii: S0022-5347(12)04446-1.
doi: 10.1016/j.juro.2012.08.009
PubMed Abstract
PMID: 23083657
UroToday.com Prostate Cancer Section
