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Biochemical recurrence-free survival after robotic-assisted laparoscopic vs open radical prostatectomy for intermediate- and high-risk prostate cancer.
Urology. 2014 Jun; 83(6):1309-15.U

Abstract

OBJECTIVE

To compare biochemical recurrence (BCR)-free survival and predictors of BCR in intermediate-risk (IR) and high-risk (HR) patients undergoing robotic-assisted laparoscopic prostatectomy (RALP) vs open radical prostatectomy (ORP).

MATERIALS AND METHODS

We conducted a retrospective study on 1336 men with D'Amico IR or HR prostate cancer who underwent RALP or ORP between 2003 and 2009. Exclusion criteria were use of neoadjuvant therapy, <6 months of follow-up, and insufficient clinicopathologic data. We compared demographic, clinical, and pathologic variables between groups. Kaplan-Meier analysis was performed to compare the 5-year BCR-free survival between groups. Multivariate models were developed to determine whether surgical approach influences BCR.

RESULTS

A total of 979 IR and HR patients (237 ORP and 742 RALP patients) met inclusion criteria. Median follow-up was shorter for RALP (43 vs 63 months; P<.001). ORP patients had a higher median prostate-specific antigen level (7.9 vs 6.7 ng/mL; P<.002), significantly more Gleason sum 8-10 tumors, and more adverse pathologic features overall. There was no difference in positive surgical margins between groups. Pathologic features including extraprostatic extension, seminal vesicle involvement, lymph node involvement, pathologic Gleason sum, and positive surgical margin were significant independent predictors of BCR in multivariate analysis. Surgical approach (RALP vs ORP) did not predict BCR when controlling for other known predictors of BCR.

CONCLUSION

Among IR and HR prostate cancer patients, the oncologic outcomes are similar between RALP and ORP. Not surprisingly, adverse pathologic features are harbingers of BCR.

Authors+Show Affiliations

Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN. Electronic address: chad.ritch@vanderbilt.edu.Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.Department of Urology, University of Oklahoma Medical Center, Oklahoma City, OK.Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

24746665

Citation

Ritch, Chad R., et al. "Biochemical Recurrence-free Survival After Robotic-assisted Laparoscopic Vs Open Radical Prostatectomy for Intermediate- and High-risk Prostate Cancer." Urology, vol. 83, no. 6, 2014, pp. 1309-15.
Ritch CR, You C, May AT, et al. Biochemical recurrence-free survival after robotic-assisted laparoscopic vs open radical prostatectomy for intermediate- and high-risk prostate cancer. Urology. 2014;83(6):1309-15.
Ritch, C. R., You, C., May, A. T., Herrell, S. D., Clark, P. E., Penson, D. F., Chang, S. S., Cookson, M. S., Smith, J. A., & Barocas, D. A. (2014). Biochemical recurrence-free survival after robotic-assisted laparoscopic vs open radical prostatectomy for intermediate- and high-risk prostate cancer. Urology, 83(6), 1309-15. https://doi.org/10.1016/j.urology.2014.02.023
Ritch CR, et al. Biochemical Recurrence-free Survival After Robotic-assisted Laparoscopic Vs Open Radical Prostatectomy for Intermediate- and High-risk Prostate Cancer. Urology. 2014;83(6):1309-15. PubMed PMID: 24746665.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biochemical recurrence-free survival after robotic-assisted laparoscopic vs open radical prostatectomy for intermediate- and high-risk prostate cancer. AU - Ritch,Chad R, AU - You,Chaochen, AU - May,Alexandra T, AU - Herrell,S Duke, AU - Clark,Peter E, AU - Penson,David F, AU - Chang,Sam S, AU - Cookson,Michael S, AU - Smith,Joseph A,Jr AU - Barocas,Daniel A, Y1 - 2014/04/18/ PY - 2013/10/03/received PY - 2014/02/11/revised PY - 2014/02/15/accepted PY - 2014/4/22/entrez PY - 2014/4/22/pubmed PY - 2014/8/6/medline SP - 1309 EP - 15 JF - Urology JO - Urology VL - 83 IS - 6 N2 - OBJECTIVE: To compare biochemical recurrence (BCR)-free survival and predictors of BCR in intermediate-risk (IR) and high-risk (HR) patients undergoing robotic-assisted laparoscopic prostatectomy (RALP) vs open radical prostatectomy (ORP). MATERIALS AND METHODS: We conducted a retrospective study on 1336 men with D'Amico IR or HR prostate cancer who underwent RALP or ORP between 2003 and 2009. Exclusion criteria were use of neoadjuvant therapy, <6 months of follow-up, and insufficient clinicopathologic data. We compared demographic, clinical, and pathologic variables between groups. Kaplan-Meier analysis was performed to compare the 5-year BCR-free survival between groups. Multivariate models were developed to determine whether surgical approach influences BCR. RESULTS: A total of 979 IR and HR patients (237 ORP and 742 RALP patients) met inclusion criteria. Median follow-up was shorter for RALP (43 vs 63 months; P<.001). ORP patients had a higher median prostate-specific antigen level (7.9 vs 6.7 ng/mL; P<.002), significantly more Gleason sum 8-10 tumors, and more adverse pathologic features overall. There was no difference in positive surgical margins between groups. Pathologic features including extraprostatic extension, seminal vesicle involvement, lymph node involvement, pathologic Gleason sum, and positive surgical margin were significant independent predictors of BCR in multivariate analysis. Surgical approach (RALP vs ORP) did not predict BCR when controlling for other known predictors of BCR. CONCLUSION: Among IR and HR prostate cancer patients, the oncologic outcomes are similar between RALP and ORP. Not surprisingly, adverse pathologic features are harbingers of BCR. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/24746665/Biochemical_recurrence_free_survival_after_robotic_assisted_laparoscopic_vs_open_radical_prostatectomy_for_intermediate__and_high_risk_prostate_cancer_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(14)00182-4 DB - PRIME DP - Unbound Medicine ER -