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• W2050910691 abstract "No AccessJournal of UrologyAdult Urology1 Dec 2012Robot-Assisted Radical Prostatectomy: 5-Year Oncological and Biochemical Outcomes Michael A. Liss, Achim Lusch, Blanca Morales, Nima Beheshti, Douglas Skarecky, Navneet Narula, Kathryn Osann, and Thomas E. Ahlering Michael A. LissMichael A. Liss Department of Urology, University of California-Irvine, Orange, California More articles by this author , Achim LuschAchim Lusch Department of Urology, University of California-Irvine, Orange, California More articles by this author , Blanca MoralesBlanca Morales Department of Urology, University of California-Irvine, Orange, California More articles by this author , Nima BeheshtiNima Beheshti Department of Urology, University of California-Irvine, Orange, California More articles by this author , Douglas SkareckyDouglas Skarecky Department of Urology, University of California-Irvine, Orange, California More articles by this author , Navneet NarulaNavneet Narula Department of Pathology, University of California-Irvine, Orange, California More articles by this author , Kathryn OsannKathryn Osann Department of Medicine, University of California-Irvine, Orange, California More articles by this author , and Thomas E. AhleringThomas E. Ahlering Department of Urology, University of California-Irvine, Orange, California Financial interest and/or other relationship with Philips, Astellas and Intuitive Surgical. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.08.009AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We investigated oncological outcomes in patients who underwent robot-assisted radical prostatectomy more than 5 years previously. Materials and Methods: Between June 2002 and August 2006 we prospectively followed 435 consecutive patients who underwent robot-assisted radical prostatectomy. Five patients were excluded from analysis, including 4 lost to followup and 1 with prior therapy. Biochemical recurrence was denoted as 1) adjuvant therapy or 2) 2 prostate specific antigen values above 0.2 ng/ml. Biochemical recurrence-free survival, and patient and tumor characteristics were investigated. Results: Mean ± SD patient age was 61.4 ± 7.1 years. A total of 289 patients (63%) had 5 or more years of followup and 4 (1%) were lost to followup. Median time to biochemical recurrence was 18 months (range 1 month to 9.1 years). Four patients (0.93%) died of prostate cancer. The 5-year biochemical recurrence-free survival rate was 84.9% (95% CI 81.4–88.4). Five-year biochemical recurrence-free survival was 94.4% (95% CI 91.7–97.1) for pT2 disease compared to 63.8% (95% CI 53.4–74.1) and 47.1% (95% CI 27.3–67.0) for pT3a and pT3b, respectively (p <0.001). Patients with a Gleason score of 3 or less + 3, 3 + 4, 4 + 3 and 4 or greater + 4 experienced a 5-year biochemical recurrence-free survival of 97%, 86%, 62% and 43%, respectively (p <0.001). Patients with positive margins had a 5-year biochemical recurrence-free survival of 60.7% (95% CI 48.7–72.7) compared to 89.6% (95% CI 86.3–92.9) in those with negative margins (p <0.001). Conclusions: This represents the third report of the oncological outcomes of robot-assisted radical prostatectomy, demonstrating a 5-year biochemical recurrence rate of approximately 14% and just below 1% prostate cancer specific mortality. References 1 : Global cancer statistics. CA Cancer J Clin2011; 61: 69. Google Scholar 2 : Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med2005; 352: 1977. Google Scholar 3 : Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. J Urol2003; 170: 1738. Link, Google Scholar 4 : Comparative effectiveness of prostate cancer surgical treatments: a population based analysis of postoperative outcomes. J Urol2010; 183: 1366. 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Google Scholar 21 : Robotic assisted laparoscopic prostatectomy versus radical retropubic prostatectomy for clinically localized prostate cancer: comparison of short-term biochemical recurrence-free survival. J Urol2010; 183: 990. Link, Google Scholar 22 : Robotic radical prostatectomy: a technique to reduce pT2 positive margins. Urology2004; 64: 1224. Google Scholar 23 : Impact of urethral stump length on continence and positive surgical margins in robot-assisted laparoscopic prostatectomy. Urology2007; 70: 173. Google Scholar 24 : Robot-assisted radical prostatectomy: current evaluation of surgical margins in clinically low-, intermediate-, and high-risk prostate cancer. J Endourol2009; 23: 1461. Google Scholar 25 : The importance of serum prostate-specific antigen testing frequency in assessing biochemical and clinical failure after prostate cancer treatment. Urology2010; 75: 467. Google Scholar © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byTewari A and Han M (2018) Commentary: Robotic Radical Prostatectomy is an Effective Approach for Treating Localized Prostate Cancer—is it Technique or Technician?Journal of Urology, VOL. 188, NO. 6, (2212-2212), Online publication date: 1-Dec-2012. Volume 188Issue 6December 2012Page: 2205-2211 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Keywordsprostatectomymortalityprostateprostatic neoplasmsroboticsMetricsAuthor Information Michael A. Liss Department of Urology, University of California-Irvine, Orange, California More articles by this author Achim Lusch Department of Urology, University of California-Irvine, Orange, California More articles by this author Blanca Morales Department of Urology, University of California-Irvine, Orange, California More articles by this author Nima Beheshti Department of Urology, University of California-Irvine, Orange, California More articles by this author Douglas Skarecky Department of Urology, University of California-Irvine, Orange, California More articles by this author Navneet Narula Department of Pathology, University of California-Irvine, Orange, California More articles by this author Kathryn Osann Department of Medicine, University of California-Irvine, Orange, California More articles by this author Thomas E. Ahlering Department of Urology, University of California-Irvine, Orange, California Financial interest and/or other relationship with Philips, Astellas and Intuitive Surgical. More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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