Biochemical Recurrence After Robot-assisted Radical Prostatectomy in a European Single-centre Cohort with a Minimum Follow-up Time of 5 Years

Sooriakumaran, Prasanna; Haendler, Leif; Nyberg, Tommy; Grönberg, Henrik; Nilsson, Andreas; Carlsson, Stefan; Hosseini, Abolfazl; Adding, Christofer; Jönsson, Martin; Ploumidis, Achilles; Egevad, Lars; Steineck, Gunnar; Wiklund, Peter

doi:10.1016/j.eururo.2012.05.024

Cited by 100 publications

(87 citation statements)

References 26 publications

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“…A greater portion of patients with high-grade disease may have affected the outcomes in this study. When stratified by pathologic stage or Gleason score, the biochemical outcomes of our series seemed similar with the results of previous RARP [11][12][13] or open [28][29][30] series. Regarding the relatively high incidence of positive surgical margin in this study, this may be partly associated with immature surgical techniques as initial cases of RARP were included in this study.…”

Section: Discussionsupporting

confidence: 85%

“…This finding is inconsistent with recent reports of the long-term outcomes after RARP, with the BCR-free survival rates in the current series seemingly inferior to published results. [11][12][13] However, our series included a higher proportion of high-grade disease and non-organ confined tumours compared with those in recent RARP series. Indeed, 14.2% of our patients had Gleason scores of 8-10 and approximately 35% had non-organ confined tumours.…”

Section: Discussionmentioning

confidence: 86%

“…Recently, Menon et al 12 published the oncologic outcomes of 1384 patients who underwent RARP with a median 5-year follow-up. Subsequently, Suardi et al 13 and Sooriakumaran et al 11 reported the biochemical outcomes after RARP in European men with a minimum follow-up of 5 years. Despite the slightly different pathologic features and inclusion criteria, the 5 years BCR-free survival rates in those studies were 86%-87%.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 Recently, several studies have reported the biochemical outcomes of RARPs with more than 5 years of median follow-up. [11][12][13] Evaluating the oncologic outcomes of RARP has great significance in several aspects. As one of the standard treatments of prostate cancer, effective oncologic control is of paramount importance.…”

Section: Introductionmentioning

confidence: 99%

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

Kim¹,

Lim²,

Shin³

et al. 2013

Asian J Androl

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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.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Kim¹,

Lim²,

Shin³

et al. 2013

Asian J Androl

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“…Still, a large proportion of patients, up to 60% depending on tumour characteristics [3,4], will develop biochemical recurrence (BCR) and may need additional treatment. BCR is usually treated with either radiotherapy (RT) or hormonal therapy (HT), depending on the likelihood that the recurrence is local only [5].…”

Section: Introductionmentioning

confidence: 99%

18F-choline PET/CT for early detection of metastases in biochemical recurrence following radical prostatectomy

et al. 2015

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Purpose: Salvage radiotherapy (SRT) for biochemical recurrence (BCR) following radical prostatectomy (RP) should if possible be added at a prostate--specific antigen (PSA) level of less than 1--2 ng/mL. The value of positron emission tomography combined with computed tomography (PET/CT) at such low PSA values is not defined. The purpose was to determine what proportion of a well--defined cohort of hormone--naïve patients who were candidates for early salvage radiotherapy had 18 F--choline PET/CT findings suggesting metastases. Materials and methods:Patients with untreated BCR following RP, PSA < 2 ng/mL, and Gleason score ≥ 7 or PSA doubling time ≤ 6 months underwent 18 F--choline PET/CT. Focal choline uptake in lymph nodes or skeletal sites were recorded.Results: PET/CT indicated metastases in 16 (28%) of 58 patients. In five (9%) patients the scans suggested bone metastases and in 11 (19%) the scans suggested regional lymph node metastases only. For patients with PSA levels < 1.0 ng/mL, the PET/CT scans indicated metastic recurrence in 25%. Conclusions:18 F--choline PET/CT may be valuable for selecting patients with BCR following RP for SRT or experimental treatment of oligometastases, even at low PSA values.

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Clinical outcomes of anterior prostate cancers treated with robotic assisted radical prostatectomy

et al. 2022

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Introduction: A prospective cohort study comparing peri-and postoperative outcomes for patients with predominantly anterior prostate cancer (APC) identified preoperatively against non-anterior prostate cancer (NAPC) treated via robotic-assisted radical prostatectomy (RARP). Patients and Methods: Of the 757 RARP's completed between January 2016 and April 2018, two comparative cohorts for anterior and an equivalent group of nonanterior prostate tumours each consisting of 152 patients were compared against each other. Data were collected on the following variables: patient age; operating consultant; preoperative PSA, ISUP grade, degree of nerve sparing; tumour staging; presence and location of positive surgical margins; PSA density, postoperative ISUP grade; treatment paradigm and postoperative PSA, erectile function, and continence outcomes with 2-year follow-up.Results: APCs were found to have significantly lower ISUP grading postoperatively; increased diagnosis via active surveillance over new diagnosis; more frequently undertaken bilateral nerve-sparing and long-term poorer continence outcomes at 18 and 24 months postoperatively (p < 0.05). Pre-and post-op PSA levels, erectile function, PSA density, positive surgical margins (PSM), age and tumour staging showed no significant differences between the APC and NAPC cohorts (p > 0.05). Conclusion:The lower ISUP grading could indicate APC as overall being less aggressive than NAPC, whereas the poorer long-term continence outcomes require further investigating. The non-significant differences amongst tumour staging, PSA density, preoperative PSA levels and PSM rates suggest that APC may not be as significant as predicted in diagnostic evaluation. Overall, this study provides useful information on the growing literature of anterior prostate cancer. Being the largest comparative cohort study to date on APC post-RARP, these results indicate the true characteristics of anterior tumours and their functional outcomes to help improve education, patient expectations and management.

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Biochemical Recurrence After Robot-assisted Radical Prostatectomy in a European Single-centre Cohort with a Minimum Follow-up Time of 5 Years

Cited by 100 publications

References 26 publications

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

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

18F-choline PET/CT for early detection of metastases in biochemical recurrence following radical prostatectomy

Clinical outcomes of anterior prostate cancers treated with robotic assisted radical prostatectomy

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