Predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy: Analysis of 359 cases with a median follow-up period of 26 months

Ali Abdel Raheem, Ki Don Chang, Mohammed Jayed Alenzi, Won Sik Ham, WoongKyu Han, Youngdeuk Choi, KoonHo Rha

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 languageEnglish
Pages (from-to)1006-1014
Number of pages9
JournalInternational Journal of Urology
Volume25
Issue number12
DOIs
Publication statusPublished - 2018 Dec 1

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Prostatectomy
Recurrence
Prostatic Neoplasms
Confidence Intervals
Neoplasm Grading
Prostate-Specific Antigen
Survival
Tumor Burden
Proportional Hazards Models
Cohort Studies
Biopsy
Safety

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

@article{6f7d8a8fdb4a44d88c002689f933f7bb,
title = "Predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy: Analysis of 359 cases with a median follow-up period of 26 months",
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.",
author = "{Abdel Raheem}, Ali and Chang, {Ki Don} and Alenzi, {Mohammed Jayed} and Ham, {Won Sik} and WoongKyu Han and Youngdeuk Choi and KoonHo Rha",
year = "2018",
month = "12",
day = "1",
doi = "10.1111/iju.13808",
language = "English",
volume = "25",
pages = "1006--1014",
journal = "International Journal of Urology",
issn = "0919-8172",
publisher = "Wiley-Blackwell",
number = "12",

}

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 journalArticle

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.

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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

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ER -