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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.
Eur Urol. 2012 Nov; 62(5):768-74.EU

Abstract

BACKGROUND

Robot-assisted radical prostatectomy (RARP) is an increasingly commonly used surgical treatment option for prostate cancer (PCa); however, its longer-term oncologic results remain uncertain.

OBJECTIVE

To report biochemical recurrence-free survival (BRFS) outcomes for men who underwent RARP ≥5 yr ago at a single European centre.

DESIGN, SETTING, AND PARTICIPANTS

A total of 944 patients underwent RARP as monotherapy for PCa from January 2002 to December 2006 at Karolinska University Hospital, Stockholm, Sweden. Standard clinicopathologic variables were recorded and entered into a secure, ethics-approved database made up of those men with registered domiciles in Stockholm. The median follow-up time was 6.3 yr (interquartile range: 5.6-7.2).

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

The outcome of this study was biochemical recurrence (BCR), defined as a confirmed prostate-specific antigen (PSA) of ≥0.2 ng/ml. Kaplan-Meier survival plots with log-rank tests, as well as Cox univariable and multivariable regression analyses, were used to determine BRFS estimates and determine predictors of PSA relapse, respectively.

RESULTS AND LIMITATIONS

The BRFS for the entire cohort at median follow-up was 84.8% (95% confidence interval [CI], 82.2-87.1); estimates at 5, 7, and 9 yr were 87.1% (95% CI, 84.8-89.2), 84.5% (95% CI, 81.8-86.8), and 82.6% (95% CI, 79.0-85.6), respectively. Nine and 19 patients died of PCa and other causes, respectively, giving end-of-follow-up Kaplan-Meier survival estimates of 98.0% (95% CI, 95.5-99.1) and 94.1% (95% CI, 90.4-96.4), respectively. Preoperative PSA >10, postoperative Gleason sum ≥4 + 3, pathologic T3 disease, positive surgical margin status, and lower surgeon volume were associated with increased risk of BCR on multivariable analysis. This study is limited by a lack of nodal status and tumour volume, which may have confounded our findings.

CONCLUSIONS

This case series from a single, high-volume, European centre demonstrates that RARP has satisfactory medium-term BRFS. Further follow-up is necessary to determine how this finding will translate into cancer-specific and overall survival outcomes.

Authors+Show Affiliations

Department of Urology, Karolinska University Hospital, Stockholm, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22633365

Citation

Sooriakumaran, Prasanna, et al. "Biochemical Recurrence After Robot-assisted Radical Prostatectomy in a European Single-centre Cohort With a Minimum Follow-up Time of 5 Years." European Urology, vol. 62, no. 5, 2012, pp. 768-74.
Sooriakumaran P, Haendler L, Nyberg T, et al. Biochemical recurrence after robot-assisted radical prostatectomy in a European single-centre cohort with a minimum follow-up time of 5 years. Eur Urol. 2012;62(5):768-74.
Sooriakumaran, P., Haendler, L., Nyberg, T., Gronberg, H., Nilsson, A., Carlsson, S., Hosseini, A., Adding, C., Jonsson, M., Ploumidis, A., Egevad, L., Steineck, G., & Wiklund, P. (2012). Biochemical recurrence after robot-assisted radical prostatectomy in a European single-centre cohort with a minimum follow-up time of 5 years. European Urology, 62(5), 768-74. https://doi.org/10.1016/j.eururo.2012.05.024
Sooriakumaran P, et al. Biochemical Recurrence After Robot-assisted Radical Prostatectomy in a European Single-centre Cohort With a Minimum Follow-up Time of 5 Years. Eur Urol. 2012;62(5):768-74. PubMed PMID: 22633365.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biochemical recurrence after robot-assisted radical prostatectomy in a European single-centre cohort with a minimum follow-up time of 5 years. AU - Sooriakumaran,Prasanna, AU - Haendler,Leif, AU - Nyberg,Tommy, AU - Gronberg,Henrik, AU - Nilsson,Andreas, AU - Carlsson,Stefan, AU - Hosseini,Abolfazl, AU - Adding,Christofer, AU - Jonsson,Martin, AU - Ploumidis,Achilles, AU - Egevad,Lars, AU - Steineck,Gunnar, AU - Wiklund,Peter, Y1 - 2012/05/18/ PY - 2012/03/07/received PY - 2012/05/09/accepted PY - 2012/5/29/entrez PY - 2012/5/29/pubmed PY - 2013/3/7/medline SP - 768 EP - 74 JF - European urology JO - Eur Urol VL - 62 IS - 5 N2 - BACKGROUND: Robot-assisted radical prostatectomy (RARP) is an increasingly commonly used surgical treatment option for prostate cancer (PCa); however, its longer-term oncologic results remain uncertain. OBJECTIVE: To report biochemical recurrence-free survival (BRFS) outcomes for men who underwent RARP ≥5 yr ago at a single European centre. DESIGN, SETTING, AND PARTICIPANTS: A total of 944 patients underwent RARP as monotherapy for PCa from January 2002 to December 2006 at Karolinska University Hospital, Stockholm, Sweden. Standard clinicopathologic variables were recorded and entered into a secure, ethics-approved database made up of those men with registered domiciles in Stockholm. The median follow-up time was 6.3 yr (interquartile range: 5.6-7.2). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The outcome of this study was biochemical recurrence (BCR), defined as a confirmed prostate-specific antigen (PSA) of ≥0.2 ng/ml. Kaplan-Meier survival plots with log-rank tests, as well as Cox univariable and multivariable regression analyses, were used to determine BRFS estimates and determine predictors of PSA relapse, respectively. RESULTS AND LIMITATIONS: The BRFS for the entire cohort at median follow-up was 84.8% (95% confidence interval [CI], 82.2-87.1); estimates at 5, 7, and 9 yr were 87.1% (95% CI, 84.8-89.2), 84.5% (95% CI, 81.8-86.8), and 82.6% (95% CI, 79.0-85.6), respectively. Nine and 19 patients died of PCa and other causes, respectively, giving end-of-follow-up Kaplan-Meier survival estimates of 98.0% (95% CI, 95.5-99.1) and 94.1% (95% CI, 90.4-96.4), respectively. Preoperative PSA >10, postoperative Gleason sum ≥4 + 3, pathologic T3 disease, positive surgical margin status, and lower surgeon volume were associated with increased risk of BCR on multivariable analysis. This study is limited by a lack of nodal status and tumour volume, which may have confounded our findings. CONCLUSIONS: This case series from a single, high-volume, European centre demonstrates that RARP has satisfactory medium-term BRFS. Further follow-up is necessary to determine how this finding will translate into cancer-specific and overall survival outcomes. SN - 1873-7560 UR - https://www.unboundmedicine.com/medline/citation/22633365/Biochemical_recurrence_after_robot_assisted_radical_prostatectomy_in_a_European_single_centre_cohort_with_a_minimum_follow_up_time_of_5_years_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(12)00600-8 DB - PRIME DP - Unbound Medicine ER -