OBJECTIVE: To assess long term biochemical recurrence free survival after radical prostatectomy according to open, laparoscopic and robot-assisted surgical approach and clinicopathological stage.
MATERIAL AND METHODS: A cohort study of 1313 consecutive patients treated by radical prostatectomy for localized or locally advanced prostate cancer between 2000 and 2013. Open surgery (63.7%), laparoscopy (10%) and robot-assisted laparoscopy (26.4%) were performed. Biochemical recurrence was defined by PSA >0,1 ng/mL. The biochemical recurrence free survival was described by Kaplan Meier method and prognostic factors were analysed by multivariable Cox regression.
RESULTS: Median follow-up was 57 months (IQR: 31-90). Ten years biochemical recurrence free survival was 88.5%, 71.6% and 53.5% respectively for low, intermediate and high-risk D'Amico groups. On multivariable analysis, the worse prognostic factor was Gleason score (P< 0.001). Positive surgical margins rate was 53% in pT3 tumours and 24% in pT2 tumours (P< 0.001). Biochemical recurrence free survival (P=0.06) and positive surgical margins rate (P=0.87) were not statistically different between the three surgical approaches.
CONCLUSION: Biochemical recurrence free survival in our study does not differ according to surgical approach and is similar to published series. Ten years biochemical recurrence free survival for high-risk tumours without hormone therapy is 54% justifying the role of surgery in the therapeutic conversations in this group of tumours.
Rizk J, Ouzzane A, Flamand V, Fantoni JC, Puech P, Leroy X, Villers A. Are you the author?
Service d'urologie, CHRU Lille, université Lille-Nord-de-France, 59000 Lille, France; Service de radiologie, CHRU Lille, université Lille-Nord-de-France, 59000 Lille, France; Institut de pathologie, CHRU Lille, université Lille-Nord-de-France, 59000 Lille, France.
Reference: Prog Urol. 2015 Mar;25(3):157-68.