PURPOSE - Cancer control outcomes following robot-assisted radical prostatectomy (RARP) for prostate cancer (PCa) remain inadequately addressed over intermediate-term (≥5-year) follow-up. We examined biochemical recurrence-free survival (BCRFS), clinical recurrence-free survival (CRFS), and cancer-specific survival (CSS) in a multi-institutional cohort of men undergoing RARP for localized PCa.
MATERIALS AND METHODS - A total of 5670 PCa patients undergoing RARP ± pelvic lymph node dissection as primary treatment modality at three tertiary care centers between 2001 and 2010 were analyzed. BCRFS, CRFS, and CSS were estimated using the Kaplan-Meier method. Cox proportional hazards model tested their association with available preoperative and postoperative parameters.
RESULTS - 43. 6 and 15. 1 % of patients had D'Amico intermediate- and high-risk disease, respectively. Over a mean (median) follow-up of 56 (50. 4) months, 797 men had a BCR, 78 men had CR, and 32 men died of PCa. Actuarial BCRFS, CRFS, and CSS, respectively, were 83. 3, 98. 6, and 99. 5 % at 5-year; 76. 5, 97. 5, and 98. 7 % at 8-year; and 73. 3, 96. 7, and 98. 4 % at 10-year follow-ups. Only 1. 7 % of patients received any adjuvant treatment. Preoperative prostate-specific antigen (PSA) and biopsy Gleason score (GS) were independent clinical predictors of BCRFS, CRFS, and CSS, while postoperatively positive surgical margin, pathological GS, pathological stage, and lymph node invasion were significantly associated with BCR and CR (all p < 0. 05).
CONCLUSIONS - Cancer control outcomes of RARP appear comparable to those reported for open and laparoscopic RP in previous literature, despite low overall rate of adjuvant treatment. Disease severity and preoperative PSA may aid in risk prognostication and defining postoperative follow-up protocols.
World journal of urology. 2016 Feb 12 [Epub ahead of print]
Firas Abdollah, Deepansh Dalela, Akshay Sood, Jesse Sammon, Wooju Jeong, Burkhard Beyer, Nicola Fossati, Craig G Rogers, Mireya Diaz-Insua, James Peabody, Alexander Haese, Francesco Montorsi, Markus Graefen, Alberto Briganti, Mani Menon
Vattikuti Urology Institute and VUI Center for Outcomes Research Analytics and Evaluation (VCORE), Henry Ford Hospital, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI, 48202-2689, USA. Vattikuti Urology Institute and VUI Center for Outcomes Research Analytics and Evaluation (VCORE), Henry Ford Hospital, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI, 48202-2689, USA. , Vattikuti Urology Institute and VUI Center for Outcomes Research Analytics and Evaluation (VCORE), Henry Ford Hospital, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI, 48202-2689, USA. , Vattikuti Urology Institute and VUI Center for Outcomes Research Analytics and Evaluation (VCORE), Henry Ford Hospital, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI, 48202-2689, USA. , Vattikuti Urology Institute and VUI Center for Outcomes Research Analytics and Evaluation (VCORE), Henry Ford Hospital, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI, 48202-2689, USA. , Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. , Department of Urology, Vita Salute San Raffaele University, Milan, Italy. , Vattikuti Urology Institute and VUI Center for Outcomes Research Analytics and Evaluation (VCORE), Henry Ford Hospital, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI, 48202-2689, USA. , Vattikuti Urology Institute and VUI Center for Outcomes Research Analytics and Evaluation (VCORE), Henry Ford Hospital, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI, 48202-2689, USA. , Vattikuti Urology Institute and VUI Center for Outcomes Research Analytics and Evaluation (VCORE), Henry Ford Hospital, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI, 48202-2689, USA. , Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. , Department of Urology, Vita Salute San Raffaele University, Milan, Italy. , Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. , Department of Urology, Vita Salute San Raffaele University, Milan, Italy. , Vattikuti Urology Institute and VUI Center for Outcomes Research Analytics and Evaluation (VCORE), Henry Ford Hospital, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI, 48202-2689, USA.