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BMC Cancer
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Research article

Robot-assisted radical prostatectomy significantly reduced biochemical recurrence compared to retro pubic radical prostatectomy

Authors: Tetsuya Fujimura, Hiroshi Fukuhara, Satoru Taguchi, Yuta Yamada, Toru Sugihara, Tohru Nakagawa, Aya Niimi, Haruki Kume, Yasuhiko Igawa, Yukio Homma

Published in: BMC Cancer | Issue 1/2017

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Abstract

Background

The pathological and oncological outcomes of retro-pubic radical prostatectomy (RRP) and robot-assisted radical prostatectomy (RARP) have not been sufficiently investigated.

Methods

Treatment-naïve patients with localized prostate cancer (PC) (n = 908; RRP, n = 490; and RARP, n = 418) were enrolled in the study. The clinicopathological outcomes, rate and localization of the positive surgical margin (PSM), localization of PSM, and biochemical recurrence (BCR)-free survival groups were compared between RRP and RARP.

Results

The median patient age and serum PSA level (ng/mL) at diagnosis were 67 years and 7.9 ng/ml, respectively, for RRP, and 67 years and 7.6 ng/ml, respectively, for RARP. The overall PSM rate with RARP was 21%, which was 11% for pT2a, 12% for pT2b, 9.8% for pT2c, 43% for pT3a, 55% for pT3b, and 0% for pT4. The overall PSM rate with RRP was 44%, which was 12% for pT2a, 18% for pT2b, 43% for pT2c, 78% for pT3a, 50% for pT3b, and 40% for pT4. The PSM rate was significantly lower for RARP in men with pT2c and pT3a (p < 0.0001 for both). Multivariate analysis showed that RARP reduced the risk of BCR (hazard ratio; 0.6, p = 0.009).

Conclusions

RARP versus RRP is associated with an improved PSM rate and BCR. To examine the cancer-specific survival, further investigations are needed.
Literature
1.
Diaz M, Peabody JO, Kapoor V, et al. Oncologic outcomes at 10 years following robotic radical prostatectomy. Eur Urol. 2015;67:1168–76.CrossRefPubMed
2.
Wallerstedt A, Tyritzis SI, Thorsteindottir T, et al. Short-term results after robot-assisted laparoscopic radical prostatectomy compared to open radical prostatectomy. Eur Urol. 2015;67:660–70.CrossRefPubMed
3.
Gardiner RA, Coughlin GD, Yaxley JW, et al. A progress report on a prospective randomized trial of open and robotic prostatectomy. Eur Urol. 2014;65:512–5.CrossRefPubMed
4.
Yaxley JW, Coughlin GD, Chambers SK, et al. Robot-assisted laparoscopic prostatectomy versus open radical retro pubic prostatectomy: early outcomes from a randomized controlled phase 3 study. Lancet. 2016;388:1057–65.CrossRefPubMed
5.
Hu JC, Gandaglia G, Karakiewicz PI, et al. Comparative effectiveness of robot-assisted versus open radical prostatectomy cancer control. Eur Urol. 2014;66:666–72.CrossRefPubMed
6.
Alemozaffar M, Sanda M, Yecies D, et al. Benchmarks for operative outcomes of robotic and open radical prostatectomy: results from the health professionals follow-up study. Eur Urol. 2015;67:432–8.CrossRefPubMed
7.
Moran PS, O’neill M, Teljeur C, et al. Robot-assisted radical prostatectomy compared with open and laparoscopic approaches: a systematic review and meta-analysis. Int J Urol. 2013;20:312–31.CrossRefPubMed
8.
Park J, Yoo DS, Song C, et al. Comparison of oncological outcomes between retro pubic radical prostatectomy and robot-assisted radical prostatectomy: an analysis stratified by surgical experience. World J Urol. 2014;32:193–9.CrossRefPubMed
9.
Fujimura T, Menon M, Fukuhara H, et al. Validation an educational program balancing surgeon training and surgical quality control during robot-assisted radical prostatectomy. Int J Urol. 2016;23:160–6.CrossRefPubMed
10.
Fukuhara H, Nishimatsu H, Suzuki M, et al. Lower incidence of inguinal hernia after radical prostatectomy using open gasless endoscopic single-site surgery. Prostate Cancer Prostatic Dis. 2011;108:4938–43.
11.
Naito S, Kuroiwa K, Kinukawa N, et al. Validation of Partin tables and development of a preoperative nomogram for Japanese patients with clinically localized prostate cancer using 2005 International Society of Urological Pathology consensus on Gleason grading: data from the clinicopathological research group for localized prostate cancer. J Urol. 2008;180:909–10.CrossRef
12.
D’Amico AV, Whittington R, Malkowicz SB, et al. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA. 1998;280:969–74.CrossRefPubMed
13.
Yossepowitch O, Briganti A, Eastham JA, et al. Positive surgical margins after radical prostatectomy: a systematic review and contemporary update. Eur Urol. 2014;65:303–13.CrossRefPubMed
14.
Galiabovitch E, Hovens CM, Peters JS, et al. Routinely reported ‘equivocal’ lymphovascular invasion in prostatectomy specimens is associated with adverse outcomes. BJU Int. doi:10.​1111/​bju.​13594.
15.
Jeon HG, Bae J, Yi JS, et al. Perineural invasion is a prognostic factor for biochemical failure after radical prostatectomy. Int J Urol. 2009;16:682–6.CrossRefPubMed
16.
Krambeck AE, DiMarco DS, Rangel LJ, et al. Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retro pubic and robot-assisted techniques. BJU Int. 2009;103:448–53.CrossRefPubMed
17.
Barocas DA, Salem S, Kordan Y, et al. Robotic assisted laparoscopic prostatectomy versus radical retro pubic prostatectomy for clinically localized prostate cancer: comparison of short-term biochemical recurrence-free survival. J Urol. 2010;183:990–6.CrossRefPubMed
18.
Thompson IM, Tangen CM, Paradelo J, et al. Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term follow up of a randomized clinical trial. J Urol. 2009;181:956–62.CrossRefPubMedPubMedCentral
19.
Dorff TB, Flaig TW, Tangen CM, et al. Adjuvant androgen deprivation for high-risk prostate cancer after radical prostatectomy: SWOG9921 study. J Clin Oncol. 2011;29:2040–5.CrossRefPubMedPubMedCentral
Metadata
Title
Robot-assisted radical prostatectomy significantly reduced biochemical recurrence compared to retro pubic radical prostatectomy
Authors
Tetsuya Fujimura
Hiroshi Fukuhara
Satoru Taguchi
Yuta Yamada
Toru Sugihara
Tohru Nakagawa
Aya Niimi
Haruki Kume
Yasuhiko Igawa
Yukio Homma
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3439-6

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