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Early oncological outcomes of robot-assisted radical prostatectomy for high-grade prostate cancer.
Early oncological outcomes of robot-assisted radical prostatectomy for high-grade prostate cancer.
- Source :
-
BJU international [BJU Int] 2010 Dec; Vol. 106 (11), pp. 1739-45. - Publication Year :
- 2010
-
Abstract
- Objective: To evaluate the oncological outcomes of patients with specimen Gleason 8 and 9 prostate cancers and to determine factors that predict biochemical recurrence-free survival (BCRFS) after robot-assisted radical prostatectomy (RARP).<br />Patients and Methods: Of 4156 patients who underwent RARP from January 2001 to 2009, we identified 368 men with Gleason 8 or 9 tumours who met the inclusion criteria. BCR was defined as a PSA level of ≥0.2 ng/mL with a second rising value. The Kaplan-Meier method and log-rank test were used to compare BCRFS while factors that predict BCRFS were determined by Cox proportional hazards modelling.<br />Results: The median age and PSA level were 62 years and 6.4 ng/mL for men with Gleason 8, and 63 years and 6.7 ng/mL for Gleason 9 cancers. The median (interquartile range, IQR) overall follow-up was 23 (10-46) months and 19 (7-37) months for Gleason 8 and 9 tumours, respectively. At 60 months the mean (se) overall BCRFS was 36 (5)% and for Gleason 8 it was 47 (6)% and for Gleason 9 it was 21 (7)% (P < 0.001). At 5 years, extraprostatic extension (pT3a) resulted in BCRFS of 52 (9)% for Gleason 8 tumours and 21 (11)% for Gleason 9 (P= 0.012). On multivariable analysis, lymph node invasion, specimen Gleason score, pathological stage and tumour volume predicted BCRFS.<br />Conclusions: Early results suggest RARP monotherapy performs comparably to RP for BCRFS in men with high-grade prostate cancer. There are significant oncological differences between Gleason 8 and 9 tumours.<br /> (© 2010 HENRY FORD HOSPITAL HEALTH SYSTEM. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL.)
- Subjects :
- Aged
Disease-Free Survival
Humans
Male
Middle Aged
Neoplasm Staging
Prospective Studies
Prostate surgery
Prostate-Specific Antigen metabolism
Prostatic Neoplasms mortality
Prostatic Neoplasms pathology
Treatment Outcome
Tumor Burden
Neoplasm Recurrence, Local pathology
Prostate pathology
Prostatectomy methods
Prostatic Neoplasms surgery
Robotics
Subjects
Details
- Language :
- English
- ISSN :
- 1464-410X
- Volume :
- 106
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- BJU international
- Publication Type :
- Academic Journal
- Accession number :
- 20575980
- Full Text :
- https://doi.org/10.1111/j.1464-410X.2010.09484.x