Robot-assisted radical prostatectomy significantly reduced biochemical recurrence compared to retro pubic radical prostatectomy

Abstract

BackgroundThe pathological and oncological outcomes of retro-pubic radical prostatectomy (RRP) and robot-assisted radical prostatectomy (RARP) have not been sufficiently investigated.MethodsTreatment-naïve patients with localized prostate cancer (PC) (n = 908; RRP, n = 490; and RARP, n = 418) were enrolled in the study. The clinicopathological outcomes, rate and localization of the positive surgical margin (PSM), localization of PSM, and biochemical recurrence (BCR)-free survival groups were compared between RRP and RARP.ResultsThe median patient age and serum PSA level (ng/mL) at diagnosis were 67 years and 7.9 ng/ml, respectively, for RRP, and 67 years and 7.6 ng/ml, respectively, for RARP. The overall PSM rate with RARP was 21%, which was 11% for pT2a, 12% for pT2b, 9.8% for pT2c, 43% for pT3a, 55% for pT3b, and 0% for pT4. The overall PSM rate with RRP was 44%, which was 12% for pT2a, 18% for pT2b, 43% for pT2c, 78% for pT3a, 50% for pT3b, and 40% for pT4. The PSM rate was significantly lower for RARP in men with pT2c and pT3a (p < 0.0001 for both). Multivariate analysis showed that RARP reduced the risk of BCR (hazard ratio; 0.6, p = 0.009).ConclusionsRARP versus RRP is associated with an improved PSM rate and BCR. To examine the cancer-specific survival, further investigations are needed.

The impact of lymphovascular invasion in patients with prostate cancer following radical prostatectomy and its association with their clinicopathological features

“…After the remaining studies (n = 69) were reviewed, 49 studies were excluded by the inclusion criteria: 39 due to the absence of HRs and/or enough extractable data, and 10 were repeated cohort publications. Finally, 20 retrospective studies [9,13–15,18–33] involving 25,570 patients were included in the study.…”

Transient acute kidney injury observed immediately after robot‑assisted radical prostatectomy but not after open radical prostatectomy

“…Since RARP started to be covered by Japanese public health insurance in 2012, most patents underwent ORP between 2011 and the first half of 2012, while majority of patients received RARP after the second half of 2012. We performed RARP using the peritoneal approach as previously described (1) and ORP using the conventional retroperitoneal approach, respectively. Patients who underwent RARP were placed in the Trendelenburg position at an angle of 25̊ from the horizontal plane.…”

Positive surgical margin is associated with biochemical recurrence risk following radical prostatectomy: a meta-analysis from high-quality retrospective cohort studies

“…Prostate cancer (PCa) is the most diagnosed malignancy and the second leading cause of cancer-related deaths among men in Western countries [ 1 ]. Radical prostatectomy (RP) has been shown to have a cancer-specific survival benefit for men with clinically localised PCa [ 2 ]. Although many patients are disease-free after surgery, nearly 30% [ 3 ] of patients still continue to experience biochemical recurrence (BCR).…”