Abstract
Objectives: Our aim was to evaluate the predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy. Methods: The study cohort consisted of 359 consecutive non-metastatic prostate cancer patients who underwent Retzius-sparing robot-assisted radical prostatectomy between November 2012 and January 2016. According to the National Comprehensive Cancer Network prostate cancer risk classification, 164 patients (45.7%) had high- or very high-risk prostate cancer. No patient received adjuvant therapy until documented biochemical recurrence. Biochemical recurrence-free survival was estimated using the Kaplan–Meier method. Univariable and multivariable Cox proportional hazards regression models were used to determine variables predictive of biochemical recurrence. Results: The median follow-up period was 26 months (interquartile range 19–38 months). The overall biochemical recurrence rate was 14.8%, and the median time to biochemical recurrence was 11 months (interquartile range 6–22 months). The 3-year biochemical recurrence-free survival probability was 71.2%, 72.1%, 88.7%, 82.3% and 95.7% in very high-, high-, intermediate-, low- and very low-risk prostate cancer, respectively (log–rank, P < 0.001). On multivariable analysis, preoperative prostate-specific antigen (hazard ratio 1.03, 95% confidence interval 1.02–1.04; P < 0.0001), percentage of maximum core involvement on biopsy (hazard ratio 1.02, 95% confidence interval 1.01–1.03; P = 0.029) and clinical stage ≥T3a (hazard ratio 2.12, 95% confidence interval 1.02–4.39; P = 0.043) were predictors of biochemical recurrence, whereas pathological Gleason score ≥8 (hazard ratio 5.63, 95% confidence interval 1.62–19.61; P = 0.007) and pathological tumor volume (hazard ratio 1.08, 95% confidence interval 1.04–1.20; P < 0.001) were the main pathological predictors of biochemical recurrence. Conclusions: Retzius-sparing robot-assisted radical prostatectomy confers effective biochemical recurrence control at the mid-term follow-up period. Preoperative prostate-specific antigen, advanced clinical stage and higher Gleason score were important predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy. Long-term oncological safety still needs to be established.
| Original language | English |
|---|---|
| Pages (from-to) | 1006-1014 |
| Number of pages | 9 |
| Journal | International Journal of Urology |
| Volume | 25 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 2018 Dec 1 |
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All Science Journal Classification (ASJC) codes
- Urology
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Predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy : Analysis of 359 cases with a median follow-up period of 26 months. / Abdel Raheem, Ali; Chang, Ki Don; Alenzi, Mohammed Jayed; Ham, Won Sik; Han, WoongKyu; Choi, Youngdeuk; Rha, KoonHo.
In: International Journal of Urology, Vol. 25, No. 12, 01.12.2018, p. 1006-1014.Research output: Contribution to journal › Article
TY - JOUR
T1 - Predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy
T2 - Analysis of 359 cases with a median follow-up period of 26 months
AU - Abdel Raheem, Ali
AU - Chang, Ki Don
AU - Alenzi, Mohammed Jayed
AU - Ham, Won Sik
AU - Han, WoongKyu
AU - Choi, Youngdeuk
AU - Rha, KoonHo
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Objectives: Our aim was to evaluate the predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy. Methods: The study cohort consisted of 359 consecutive non-metastatic prostate cancer patients who underwent Retzius-sparing robot-assisted radical prostatectomy between November 2012 and January 2016. According to the National Comprehensive Cancer Network prostate cancer risk classification, 164 patients (45.7%) had high- or very high-risk prostate cancer. No patient received adjuvant therapy until documented biochemical recurrence. Biochemical recurrence-free survival was estimated using the Kaplan–Meier method. Univariable and multivariable Cox proportional hazards regression models were used to determine variables predictive of biochemical recurrence. Results: The median follow-up period was 26 months (interquartile range 19–38 months). The overall biochemical recurrence rate was 14.8%, and the median time to biochemical recurrence was 11 months (interquartile range 6–22 months). The 3-year biochemical recurrence-free survival probability was 71.2%, 72.1%, 88.7%, 82.3% and 95.7% in very high-, high-, intermediate-, low- and very low-risk prostate cancer, respectively (log–rank, P < 0.001). On multivariable analysis, preoperative prostate-specific antigen (hazard ratio 1.03, 95% confidence interval 1.02–1.04; P < 0.0001), percentage of maximum core involvement on biopsy (hazard ratio 1.02, 95% confidence interval 1.01–1.03; P = 0.029) and clinical stage ≥T3a (hazard ratio 2.12, 95% confidence interval 1.02–4.39; P = 0.043) were predictors of biochemical recurrence, whereas pathological Gleason score ≥8 (hazard ratio 5.63, 95% confidence interval 1.62–19.61; P = 0.007) and pathological tumor volume (hazard ratio 1.08, 95% confidence interval 1.04–1.20; P < 0.001) were the main pathological predictors of biochemical recurrence. Conclusions: Retzius-sparing robot-assisted radical prostatectomy confers effective biochemical recurrence control at the mid-term follow-up period. Preoperative prostate-specific antigen, advanced clinical stage and higher Gleason score were important predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy. Long-term oncological safety still needs to be established.
AB - Objectives: Our aim was to evaluate the predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy. Methods: The study cohort consisted of 359 consecutive non-metastatic prostate cancer patients who underwent Retzius-sparing robot-assisted radical prostatectomy between November 2012 and January 2016. According to the National Comprehensive Cancer Network prostate cancer risk classification, 164 patients (45.7%) had high- or very high-risk prostate cancer. No patient received adjuvant therapy until documented biochemical recurrence. Biochemical recurrence-free survival was estimated using the Kaplan–Meier method. Univariable and multivariable Cox proportional hazards regression models were used to determine variables predictive of biochemical recurrence. Results: The median follow-up period was 26 months (interquartile range 19–38 months). The overall biochemical recurrence rate was 14.8%, and the median time to biochemical recurrence was 11 months (interquartile range 6–22 months). The 3-year biochemical recurrence-free survival probability was 71.2%, 72.1%, 88.7%, 82.3% and 95.7% in very high-, high-, intermediate-, low- and very low-risk prostate cancer, respectively (log–rank, P < 0.001). On multivariable analysis, preoperative prostate-specific antigen (hazard ratio 1.03, 95% confidence interval 1.02–1.04; P < 0.0001), percentage of maximum core involvement on biopsy (hazard ratio 1.02, 95% confidence interval 1.01–1.03; P = 0.029) and clinical stage ≥T3a (hazard ratio 2.12, 95% confidence interval 1.02–4.39; P = 0.043) were predictors of biochemical recurrence, whereas pathological Gleason score ≥8 (hazard ratio 5.63, 95% confidence interval 1.62–19.61; P = 0.007) and pathological tumor volume (hazard ratio 1.08, 95% confidence interval 1.04–1.20; P < 0.001) were the main pathological predictors of biochemical recurrence. Conclusions: Retzius-sparing robot-assisted radical prostatectomy confers effective biochemical recurrence control at the mid-term follow-up period. Preoperative prostate-specific antigen, advanced clinical stage and higher Gleason score were important predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy. Long-term oncological safety still needs to be established.
UR - http://www.scopus.com/inward/record.url?scp=85054176559&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85054176559&partnerID=8YFLogxK
U2 - 10.1111/iju.13808
DO - 10.1111/iju.13808
M3 - Article
C2 - 30276864
AN - SCOPUS:85054176559
VL - 25
SP - 1006
EP - 1014
JO - International Journal of Urology
JF - International Journal of Urology
SN - 0919-8172
IS - 12
ER -