TAIPEI, TAIWAN (UroToday.com) - Introduction and Objectives: Interestingly, robot assisted radical prostatectomy (RARP) in the treatment of high-risk prostate cancer has not been well studied to date. We sought to evaluate all patients with high-risk prostate cancer undergoing RARP at our institution.
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Methods: We performed a single-institution, single-surgeon review of 3,120 patients who underwent RARP from 2005 to 2012. Patients were identified who underwent RARP for high-risk disease as determined by D’Amico classification (Gleason 8–10, stage ≥T2c, and or PSA ≥20). Perioperative data was evaluated from a prospectively maintained RARP database. Treatment was considered a failure with PSA levels ≥0.2.
Results: In total, 319 patients were identified that met high-risk classification. The median age was 61. The median BMI was 28.29. Follow-up ranged from 11 to 98 months. 1-year biochemical recurrence free survival (1-RFS) was 81.8%. 2-year biochemical recurrence free survival (2-RFS) was 63.3%. Gleason score of 8–10 was the most common pre-operative high-risk identifier (64%). Positive surgical margins occurred in 29.8% of patients. Lymph node dissection was performed on 307 patients (96%). The 12 patients that did not receive a lymph node dissection had surgery prior to 2009. In total, 12 patients (3.9%) were found to have positive lymph node involvement.
Conclusions: We present our data for the treatment of high-risk prostate cancer with RARP. Consistent with recent, but limited data, RARP appears to be an effective initial treatment for high-risk prostate cancer. Further follow-up for these patients remains necessary to help better understand long-term outcomes following RARP for high-risk prostate cancer.
Source of Funding: None
|Listen to an interview with Benjamin Katz, one of the authors of this study.|
Presented by Andrew J. Lightfoot, Giovanni Greaves, Sue-Jean Yu, Elton Llukani, Benjamin F. Katz, Alice McGill, Kelly Monohan, Phillip Mucksavage, and David I. Lee at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan
University of Pennsylvania, Philadelphia, PA USA