Biochemical outcomes after robot-assisted radical prostatectomy in patients with follow-up more than 5-years

Abstract

In this study, we assessed biochemical outcomes after robot-assisted radical prostatectomy (RARP). Between July 2005 and November 2007, one hundred and seventy-six consecutive patients treated by RARP without neoadjuvant treatment were included in this study. All procedures were performed by a single surgeon and the median follow-up period was 60 months (interquartile range (IQR): 59-69). The median prostate specific antigen was 7.50 ng ml 21 (IQR: 5.14-11.45) and 39.2% of the patients were classified as intermediate risk and 15.3% were classified as high risk; on final pathological examination, 35.2% of the patients had non-organ confined disease and 37.5% and 14.2% had Gleason scores of 7 and 8-10, respectively. The biochemical recurrence (BCR)-free survival rates at 3 and 5 years were 85.6% and 81.2%, respectively. The 5-year BCR-free survival rates stratified by pathologic Gleason scores were 93.1% in Gleason scores of 6 or less, 74.5% in a Gleason score of 7, and 58.1% in Gleason scores of 8 or greater, respectively (P,0.001). When stratified by pathologic stage, the BCR-free survival rates were 89.8% in pT2 patients, 66.2% in pT3a patients, and 39.3% in pT3b patients at 5 years following RARP, respectively (P,0.001). Preoperative prostate-specific antigen (PSA), pathologic stage, postoperative Gleason score and surgical margin status were independently associated with BCR in multivariate analysis. In this study, we report biochemical outcomes after RARP with the longest follow-up periods to date in Asian men. We found that robotic surgery provided satisfactory biochemical outcomes, and that RARP is a safe and effective procedure in terms of oncologic outcomes.

Prediction of biochemical recurrence after robot‐assisted radical prostatectomy: Analysis of 784 Japanese patients

“…Kim et al reported the Korean BCRFS rate after RARP, which seems to be in agreement with our rates. 24 They mentioned that their series included a higher proportion of high-grade disease and nonorgan-confined tumors compared with those in other RARP series, and a significant proportion of high-grade disease was also noted in studies of Chinese and Japanese populations. In addition, other Japanese BCRFS rates including open or laparoscopic RP were lower than the rate in the present study.…”

Stratified analysis of 800 Asian patients after robot‐assisted radical prostatectomy with a median 64 months of follow up

“…Our group was the first to report on BCR after RARP with a median follow up of 60 months; however, our previous studies had some limitations: a small number of patients (n = 176), the presence of LN metastases was not included in the analysis of BCR and we did not report on survival rates. 6 In the current study, we extended our analysis to present our entire updated experience with the largest reported RARP series among an Asian population (n = 800) and the longest follow-up period (median follow up of 64 months). We recorded the nodal status and its impact on BCR, as most of our patients (97.1%) underwent PLND.…”

“…Unlike ORP, reports on long-term oncological follow up after RARP are insufficient. Just a few studies reported 5-year oncological outcomes after RARP, [3][4][5][6] with only one recent study having a 10-year follow-up period. 7 Previously, we reported BRC in a small cohort of patients (n = 176) who underwent RARP at our institution (Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea) between 2005 and 2007, and the BCRFS rates at 3 and 5 years were 85.6% and 81.2%, respectively.…”

“…7 Previously, we reported BRC in a small cohort of patients (n = 176) who underwent RARP at our institution (Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea) between 2005 and 2007, and the BCRFS rates at 3 and 5 years were 85.6% and 81.2%, respectively. 6 In the current study, we aimed to evaluate overall oncological outcomes in patients undergoing RARP at a high-volume tertiary care center. To our knowledge, the present study is the largest RARP series (n = 800) in Asia, with a median follow up of 64 months.…”

“…Unlike ORP, reports on long-term oncological follow up after RARP are insufficient. Just a few studies reported 5-year oncological outcomes after RARP, [3][4][5][6] with only one recent study having a 10-year follow-up period.…”