Risk factors for biochemical recurrence after robotic assisted radical prostatectomy: A single surgeon experience

Ryuta Tanimoto, Yomi Fashola, Kymora B. Scotland, Anne E. Calvaresi, Leonard G. Gomella, Edouard J. Trabulsi, Costas D. Lallas

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Radical prostatectomy is a standard surgical treatment of clinically localized prostate cancer. Margin status has been found to be an independent predictor of biochemical recurrence (BCR) after open radical prostatectomy in several large series but this is still controversy in Robotic Assisted Radical Prostatectomy (RARP) series. We therefore wanted to investigate the prognostic significance of positive surgical margin (PSM) and other pathological factors on BCR in patients treated with RARP by a single surgeon. Methods: Prospectively collected data of 439 patients treated with RARP between October 2005 and June 2013 by a single surgeon at a single institution were analyzed. BCR was defined as follow-up PSA level∈>∈0.2 ng/ml on two separate occasions or patients who had to undergo salvage therapy. Kaplan Meier curves and Log Rank test were used to compare the risk of BCR. Univariate and Multivariate Cox Regression analyses were performed to determine the prognostic impact of age, BMI, prostate weight, PSA prior to surgery, pathological T-stage, pathological Gleason sum, PSM and operative period. Results: In this study period, 34 out of 439 had BCR, giving an overall BCR rate of 7.7% for this cohort. Overall 2- and 3-year BCR-free survival rates were 93% and 88%, respectively. Patients with a PSM had a 2-year BCR free survival of 88% compared to 94% in those with negative margins (p∈<∈.0001). On the multivariate analysis, PSM as well as pathological Gleason sum∈>∈= 8, PSA, pathological stage and operative period were significantly associated with BCR. Conclusions: In our case series of RARP performed by a single surgeon, PSM as well as pathological Gleason sum, PSA, pathological stage and early operative period for this surgeon were the independent predictors of BCR.

Original languageEnglish
Article number27
JournalBMC Urology
Volume15
Issue number1
DOIs
Publication statusPublished - Apr 8 2015
Externally publishedYes

Fingerprint

Robotics
Prostatectomy
Recurrence
Surgeons
Salvage Therapy
Prostate
Prostatic Neoplasms
Survival Rate
Regression Analysis
Weights and Measures
Survival
Margins of Excision

Keywords

  • Biochemical recurrence
  • Biochemical recurrence free survival
  • Cox regression analysis
  • Positive surgical margin
  • Robotic assisted radical prostatectomy

ASJC Scopus subject areas

  • Reproductive Medicine
  • Urology

Cite this

Tanimoto, R., Fashola, Y., Scotland, K. B., Calvaresi, A. E., Gomella, L. G., Trabulsi, E. J., & Lallas, C. D. (2015). Risk factors for biochemical recurrence after robotic assisted radical prostatectomy: A single surgeon experience. BMC Urology, 15(1), [27]. https://doi.org/10.1186/s12894-015-0024-7

Risk factors for biochemical recurrence after robotic assisted radical prostatectomy : A single surgeon experience. / Tanimoto, Ryuta; Fashola, Yomi; Scotland, Kymora B.; Calvaresi, Anne E.; Gomella, Leonard G.; Trabulsi, Edouard J.; Lallas, Costas D.

In: BMC Urology, Vol. 15, No. 1, 27, 08.04.2015.

Research output: Contribution to journalArticle

Tanimoto, R, Fashola, Y, Scotland, KB, Calvaresi, AE, Gomella, LG, Trabulsi, EJ & Lallas, CD 2015, 'Risk factors for biochemical recurrence after robotic assisted radical prostatectomy: A single surgeon experience', BMC Urology, vol. 15, no. 1, 27. https://doi.org/10.1186/s12894-015-0024-7
Tanimoto, Ryuta ; Fashola, Yomi ; Scotland, Kymora B. ; Calvaresi, Anne E. ; Gomella, Leonard G. ; Trabulsi, Edouard J. ; Lallas, Costas D. / Risk factors for biochemical recurrence after robotic assisted radical prostatectomy : A single surgeon experience. In: BMC Urology. 2015 ; Vol. 15, No. 1.
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abstract = "Background: Radical prostatectomy is a standard surgical treatment of clinically localized prostate cancer. Margin status has been found to be an independent predictor of biochemical recurrence (BCR) after open radical prostatectomy in several large series but this is still controversy in Robotic Assisted Radical Prostatectomy (RARP) series. We therefore wanted to investigate the prognostic significance of positive surgical margin (PSM) and other pathological factors on BCR in patients treated with RARP by a single surgeon. Methods: Prospectively collected data of 439 patients treated with RARP between October 2005 and June 2013 by a single surgeon at a single institution were analyzed. BCR was defined as follow-up PSA level∈>∈0.2 ng/ml on two separate occasions or patients who had to undergo salvage therapy. Kaplan Meier curves and Log Rank test were used to compare the risk of BCR. Univariate and Multivariate Cox Regression analyses were performed to determine the prognostic impact of age, BMI, prostate weight, PSA prior to surgery, pathological T-stage, pathological Gleason sum, PSM and operative period. Results: In this study period, 34 out of 439 had BCR, giving an overall BCR rate of 7.7{\%} for this cohort. Overall 2- and 3-year BCR-free survival rates were 93{\%} and 88{\%}, respectively. Patients with a PSM had a 2-year BCR free survival of 88{\%} compared to 94{\%} in those with negative margins (p∈<∈.0001). On the multivariate analysis, PSM as well as pathological Gleason sum∈>∈= 8, PSA, pathological stage and operative period were significantly associated with BCR. Conclusions: In our case series of RARP performed by a single surgeon, PSM as well as pathological Gleason sum, PSA, pathological stage and early operative period for this surgeon were the independent predictors of BCR.",
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AU - Fashola, Yomi

AU - Scotland, Kymora B.

AU - Calvaresi, Anne E.

AU - Gomella, Leonard G.

AU - Trabulsi, Edouard J.

AU - Lallas, Costas D.

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N2 - Background: Radical prostatectomy is a standard surgical treatment of clinically localized prostate cancer. Margin status has been found to be an independent predictor of biochemical recurrence (BCR) after open radical prostatectomy in several large series but this is still controversy in Robotic Assisted Radical Prostatectomy (RARP) series. We therefore wanted to investigate the prognostic significance of positive surgical margin (PSM) and other pathological factors on BCR in patients treated with RARP by a single surgeon. Methods: Prospectively collected data of 439 patients treated with RARP between October 2005 and June 2013 by a single surgeon at a single institution were analyzed. BCR was defined as follow-up PSA level∈>∈0.2 ng/ml on two separate occasions or patients who had to undergo salvage therapy. Kaplan Meier curves and Log Rank test were used to compare the risk of BCR. Univariate and Multivariate Cox Regression analyses were performed to determine the prognostic impact of age, BMI, prostate weight, PSA prior to surgery, pathological T-stage, pathological Gleason sum, PSM and operative period. Results: In this study period, 34 out of 439 had BCR, giving an overall BCR rate of 7.7% for this cohort. Overall 2- and 3-year BCR-free survival rates were 93% and 88%, respectively. Patients with a PSM had a 2-year BCR free survival of 88% compared to 94% in those with negative margins (p∈<∈.0001). On the multivariate analysis, PSM as well as pathological Gleason sum∈>∈= 8, PSA, pathological stage and operative period were significantly associated with BCR. Conclusions: In our case series of RARP performed by a single surgeon, PSM as well as pathological Gleason sum, PSA, pathological stage and early operative period for this surgeon were the independent predictors of BCR.

AB - Background: Radical prostatectomy is a standard surgical treatment of clinically localized prostate cancer. Margin status has been found to be an independent predictor of biochemical recurrence (BCR) after open radical prostatectomy in several large series but this is still controversy in Robotic Assisted Radical Prostatectomy (RARP) series. We therefore wanted to investigate the prognostic significance of positive surgical margin (PSM) and other pathological factors on BCR in patients treated with RARP by a single surgeon. Methods: Prospectively collected data of 439 patients treated with RARP between October 2005 and June 2013 by a single surgeon at a single institution were analyzed. BCR was defined as follow-up PSA level∈>∈0.2 ng/ml on two separate occasions or patients who had to undergo salvage therapy. Kaplan Meier curves and Log Rank test were used to compare the risk of BCR. Univariate and Multivariate Cox Regression analyses were performed to determine the prognostic impact of age, BMI, prostate weight, PSA prior to surgery, pathological T-stage, pathological Gleason sum, PSM and operative period. Results: In this study period, 34 out of 439 had BCR, giving an overall BCR rate of 7.7% for this cohort. Overall 2- and 3-year BCR-free survival rates were 93% and 88%, respectively. Patients with a PSM had a 2-year BCR free survival of 88% compared to 94% in those with negative margins (p∈<∈.0001). On the multivariate analysis, PSM as well as pathological Gleason sum∈>∈= 8, PSA, pathological stage and operative period were significantly associated with BCR. Conclusions: In our case series of RARP performed by a single surgeon, PSM as well as pathological Gleason sum, PSA, pathological stage and early operative period for this surgeon were the independent predictors of BCR.

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KW - Biochemical recurrence free survival

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