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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.
Int J Urol. 2018 12; 25(12):1006-1014.IJ

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.

Authors+Show Affiliations

Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. Department of Urology, Tanta University Medical School, Tanta, Egypt.Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. Department of Urology, Al Jouf University, Sakakah, Saudi Arabia.Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

Pub Type(s)

Journal Article
Video-Audio Media

Language

eng

PubMed ID

30276864

Citation

Abdel Raheem, Ali, et al. "Predictors of Biochemical Recurrence After Retzius-sparing Robot-assisted Radical Prostatectomy: Analysis of 359 Cases With a Median Follow-up Period of 26 Months." International Journal of Urology : Official Journal of the Japanese Urological Association, vol. 25, no. 12, 2018, pp. 1006-1014.
Abdel Raheem A, Chang KD, Alenzi MJ, et al. Predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy: Analysis of 359 cases with a median follow-up period of 26 months. Int J Urol. 2018;25(12):1006-1014.
Abdel Raheem, A., Chang, K. D., Alenzi, M. J., Ham, W. S., Han, W. K., Choi, Y. D., & Rha, K. H. (2018). Predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy: Analysis of 359 cases with a median follow-up period of 26 months. International Journal of Urology : Official Journal of the Japanese Urological Association, 25(12), 1006-1014. https://doi.org/10.1111/iju.13808
Abdel Raheem A, et al. Predictors of Biochemical Recurrence After Retzius-sparing Robot-assisted Radical Prostatectomy: Analysis of 359 Cases With a Median Follow-up Period of 26 Months. Int J Urol. 2018;25(12):1006-1014. PubMed PMID: 30276864.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy: 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,Woong Kyu, AU - Choi,Young Deuk, AU - Rha,Koon Ho, Y1 - 2018/10/01/ PY - 2018/01/28/received PY - 2018/08/07/accepted PY - 2018/10/3/pubmed PY - 2019/6/7/medline PY - 2018/10/3/entrez KW - Retzius-sparing KW - biochemical recurrence KW - prostate cancer SP - 1006 EP - 1014 JF - International journal of urology : official journal of the Japanese Urological Association JO - Int. J. Urol. VL - 25 IS - 12 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. SN - 1442-2042 UR - https://www.unboundmedicine.com/medline/citation/30276864/Predictors_of_biochemical_recurrence_after_Retzius_sparing_robot_assisted_radical_prostatectomy:_Analysis_of_359_cases_with_a_median_follow_up_period_of_26_months_ L2 - https://doi.org/10.1111/iju.13808 DB - PRIME DP - Unbound Medicine ER -