Comparative analysis of oncologic outcomes for open vs. robot-assisted radical prostatectomy in high-risk prostate cancer.
10.4111/kju.2015.56.8.572
- Author:
Donghyun LEE
1
;
Seung Kwon CHOI
;
Jinsung PARK
;
Myungsun SHIM
;
Aram KIM
;
Sangmi LEE
;
Cheryn SONG
;
Hanjong AHN
Author Information
1. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. hjahn@amc.seoul.kr
- Publication Type:Comparative Study ; Original Article
- Keywords:
Prostatic neoplasms;
Prostatectomy;
Treatment outcome
- MeSH:
Aged;
Databases, Factual;
Humans;
Kaplan-Meier Estimate;
Lymphatic Metastasis;
Male;
Middle Aged;
Neoplasm Grading;
Neoplasm Staging;
Prostatectomy/*methods;
Prostatic Neoplasms/pathology/*surgery;
Robotic Surgical Procedures/*methods;
Treatment Outcome
- From:Korean Journal of Urology
2015;56(8):572-579
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate the oncologic outcomes of robot-assisted radical prostatectomy (RARP) in high-risk prostate cancer (PCa), we compared the surgical margin status and biochemical recurrence-free survival (BCRFS) rates between retropubic radical prostatectomy (RRP) and RARP. MATERIALS AND METHODS: A comparative analysis was conducted of high-risk PCa patients who underwent RRP or RARP by a single surgeon from 2007 to 2013. High-risk PCa was defined as clinical stage> or =T3a, biopsy Gleason score 8-10, or prostate-specific antigen>20 ng/mL. Propensity score matching was performed to minimize selection bias, and all possible preoperative and postoperative confounders were matched. A Kaplan-Meier analysis was performed to assess the 5-year BCRFS, and Cox regression models were used to evaluate the effect of the surgical approach on biochemical recurrence. RESULTS: A total of 356 high-risk PCa patients (106 [29.8%] RRP and 250 [70.2%] RARP) were included in the final cohort analyzed. Before adjustment, the mean percentage of positive cores on biopsy and pathologic stage were poorer for RRP versus RARP (p=0.036 vs. p=0.054, respectively). The unadjusted 5-year BCRFS rates were better for RARP than for RRP (RRP vs. RARP: 48.1% vs. 64.4%, p=0.021). After adjustment for preoperative variables, the 5-year BCRFS rates were similar between RRP and RARP patients (48.5% vs. 59.6%, p=0.131). The surgical approach did not predict biochemical recurrence in multivariate analysis. CONCLUSIONS: Five-year BCRFS rates of RARP are comparable to RRP in high-risk PCa. RARP is a feasible treatment option for high-risk PCa.
