Robot-assisted radical prostatectomy: 5-year oncological and biochemical outcomes

Michael A. Liss, Achim Lusch, Blanca Morales, Nima Beheshti, Douglas Skarecky, Navneet Narula, Kathryn Osann, Thomas E. Ahlering

Research output: Contribution to journalArticlepeer-review

43 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)2205-2211
Number of pages7
JournalJournal of Urology
Volume188
Issue number6
DOIs
StatePublished - Dec 2012

Keywords

  • mortality
  • prostate
  • prostatectomy
  • prostatic neoplasms
  • robotics

ASJC Scopus subject areas

  • Urology

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