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.
Written by:
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.
doi: 10.1016/j.purol.2014.12.004
PubMed Abstract
PMID: 25614075