Impact of positive surgical margin status in predicting early biochemical recurrence after robot-assisted radical prostatectomy

Morizane, Shuichi; Yumioka, Tetsuya; Makishima, Karen; Tsounapi, Panagiota; Iwamoto, Hideto; Hikita, Katsuya; Honda, Masashi; Umekita, Yoshihisa; Takenaka, Atsushi

doi:10.1007/s10147-021-01977-x

Cited by 17 publications

(15 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Robot-assisted RP (RARP), a minimally invasive procedure, may be advantageous in reducing bleeding and transfusion rates [ 3 ]. Indeed, RARP has been widely accepted as a surgical procedure for the management of non-metastatic PCa [ 4 ], with its use greatly increasing over the past decade. Risk classification has been proposed as a method for evaluating the probability of recurrence and prognosis of PCa [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Gleason Grade 3 as a Predictive Factor for Biochemical Recurrence after Robot-Assisted Radical Prostatectomy: A Retrospective Multicenter Cohort Study in Japan (The MSUG94 Group)

et al. 2022

View full text Add to dashboard Cite

Background and Objectives: This study’s objective was to examine patients treated with robot-assisted radical prostatectomy (RARP) for intermediate-risk prostate cancer (IR-PCa), and to identify preoperative risk factors for biochemical recurrence (BCR) in these patients in Japan. Materials and Methods: We conducted a retrospective multicenter cohort study of patients with PCa who underwent RARP at 10 institutions in Japan. A total of 3195 patients were enrolled in this study. We focused on patients with IR-PCa who underwent RARP. We obtained data on pre- and postoperative covariates from the enrolled patients. Biochemical recurrence-free survival was the primary endpoint of this study. We also identified useful preoperative predictive factors for BCR in patients with IR-PCa after RARP. Results: A total of 1144 patients with IR-PCa were enrolled in this study. The median follow-up period was 23.7 months. At the end of the follow-up period, 94 (8.2%) patients developed BCR. The 2 and 3 year biochemical recurrence-free survival (BRFS) rates were 92.2% and 90.2%, respectively. Using the Kaplan–Meier method, Gleason grade (GG) 3 was significantly associated with poor BRFS compared with ≤GG 2. In multivariate analysis, GG 3 was a significant predictive factor for BCR in patients with IR-PCa. Conclusions: The results of the study indicated a significant relationship between GG 3 and post-RARP BCR in patients with IR-PCa.

show abstract

Section: Introductionmentioning

confidence: 99%

The Impact of Gleason Grade 3 as a Predictive Factor for Biochemical Recurrence after Robot-Assisted Radical Prostatectomy: A Retrospective Multicenter Cohort Study in Japan (The MSUG94 Group)

et al. 2022

View full text Add to dashboard Cite

show abstract

“…9 Morizane et al reported that lymph node metastasis, GS of ≥7 with a PSM, and a maximum PSM length of >6 mm were significant predictors of BCR in multivariate analysis. 4 Conversely, RARP has potential benefits such as a lower PSM rate compared with that following open RP, owing to better visibility and less blood loss. 21 Fifteen studies enrolling a total of approximately 3000 RP patients with PCa have shown that RARP decreases the rate of PSMs for organ-confined tumors (P < .001).…”

Section: Discussionmentioning

confidence: 99%

Short‐term oncological and surgical outcomes of robot‐assisted radical prostatectomy: A retrospective multicenter cohort study in Japan (the MSUG94 group)

Kato

Ebara

Tatenuma

et al. 2022

Asian J Endoscop Surgery

View full text Add to dashboard Cite

Introduction: We evaluated oncological outcomes of patients undergoing robot-assisted radical prostatectomy (RARP) for prostate cancer (PCa) and their perioperative complications in Japan. We investigated clinical and pathological covariates to predict biochemical recurrence (BCR) after RARP.Methods: A retrospective multicenter cohort study was conducted in RARP patients with PCa at 10 institutions in Japan. Pre-and postoperative covariates were collected from enrolled patients. The primary endpoint was defined as biochemical recurrence-free survival (BRFS). Additionally, the association between BCR and clinicopathological covariates was determined.Results: We enrolled 2670 patients in this study. The median follow-up period was 26.0 months. RARP-related perioperative complications were identified in 198 patients (7.4%), including 69 patients (2.6%) with grade 3/4 complications according to the Clavien-Dindo classification. The 2-year BRFS was 88.0%.Using the Kaplan-Meier method, initial prostate-specific antigen (PSA) level of ≤7.6 ng/mL, biopsy and pathological Gleason score (GS) of ≤7, clinical and pathological T1/2, and low/intermediate risks according to the National Comprehensive Cancer Network risk classification, and negative surgical margin status had significant BRFS than their counterparts. In multivariate analysis, initial PSA, biopsy and pathological GS, clinical and pathological T stage, and surgical margin status significantly correlated with BCR after RARP. Conclusion: In this study, RARP achieved a lower incidence of perioperative complications than other studies. K E Y W O R D Soncological outcomes and perioperative complications, prostate cancer, robot-assisted radical prostatectomy

show abstract

“…Adjuvant androgen deprivation therapy plus adjuvant radiotherapy yielded a survival benefit compared to observation and adjuvant androgen deprivation therapy ( 5 ), and distinct treatment before or after surgery could influence the survival analysis of LND. Positive surgical margin status was not recorded; a positive surgical margin length of > 6.0 mm ( p = 0.003) was a significant predictor of biochemical recurrence ( 29 ). Another factor that was not reported but influences survival was the number of positive lymph nodes; a higher number of positive lymph nodes resulted in a poorer prognosis ( 5 ), three positive lymph nodes represent the best prognostic cutoff in node-positive PCa patients, and patients with one to three positive lymph nodes showed higher cancer-specific mortality-free survival estimates as compared with their counterparts with >3 metastatic lymph nodes ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

The survival benefit of different lymph node yields in radical prostatectomy for pN1M0 prostate cancer patients: Implications from a population-based study

Liu

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

Background and objectivesThe extent and survival benefits of lymph node dissection (LND) in radical prostatectomy (RP) for pN1M0 prostate cancer (PCa) patients remained unclear and were controversial. This study aimed to determine the survival benefit of different lymph node yields in RP for pN1M0 PCa patients.MethodspN1M0 PCa patients who received RP and LND were identified in Surveillance Epidemiology and End Results (SEER) (2010–2015). Patients were divided into two groups in SEER based on the removal of one to three regional lymph nodes (LND1 group) or four or more regional lymph nodes (LND4 group). Kaplan–Meier methods were used to calculate cancer-specific survival (CSS) and overall survival (OS).ResultsIn total, 2,200 patients were identified; 264 patients received LND1 and 1,936 patients received LND4. CSS had no significant difference between the LND4 and LND1 groups (101mon vs. 98mon, p = 0.064), and OS was higher in LND4 patients compared with LND1 patients (97mon vs. 93mon, p = 0.024); for patients with Gleason score = 9 or 10 and T3b or T4, 5-year OS was higher in patients undergoing LND4 (80.9%; 95% CI, 79.0–82.8) compared with those undergoing LND1 (67.5%; 95% CI, 60.8–74.2) (p = 0.009).ConclusionMore lymph node yield provided better survival for patients with Gleason score = 9 or 10 and T3b or T4, but not for other pN1M0 PCa patients. The extent of LND would be determined after a comprehensive evaluation including Gleason score, tumor stage, and the general condition of the patient.

show abstract

Impact of positive surgical margin status in predicting early biochemical recurrence after robot-assisted radical prostatectomy

Cited by 17 publications

References 27 publications

The Impact of Gleason Grade 3 as a Predictive Factor for Biochemical Recurrence after Robot-Assisted Radical Prostatectomy: A Retrospective Multicenter Cohort Study in Japan (The MSUG94 Group)

The Impact of Gleason Grade 3 as a Predictive Factor for Biochemical Recurrence after Robot-Assisted Radical Prostatectomy: A Retrospective Multicenter Cohort Study in Japan (The MSUG94 Group)

Short‐term oncological and surgical outcomes of robot‐assisted radical prostatectomy: A retrospective multicenter cohort study in Japan (the MSUG94 group)

The survival benefit of different lymph node yields in radical prostatectomy for pN1M0 prostate cancer patients: Implications from a population-based study

Contact Info

Product

Resources

About