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Does robot-assisted radical prostatectomy benefit patients with prostate cancer and bone oligometastases?

 Won Sik Jang  ;  Myung Soo Kim  ;  Won Sik Jeong  ;  Ki Don Chang  ;  Kang Su Cho  ;  Won Sik Ham  ;  Koon Ho Rha  ;  Sung Joon Hong  ;  Young Deuk Choi 
 BJU International, Vol.121(2) : 225-231, 2018 
Journal Title
 BJU International 
Issue Date
Aged ; Androgen Antagonists/therapeutic use ; Bone Neoplasms/*secondary ; Disease Progression ; Disease-Free Survival ; Humans ; Male ; Middle Aged ; Prostatectomy/*methods ; Prostatic Neoplasms/complications/pathology/*surgery/therapy ; Retrospective Studies ; *Robotic Surgical Procedures ; Survival Rate ; Treatment Outcome ; Urologic Diseases/etiology
#PCSM ; #ProstateCancer ; local treatment ; metastatic ; radical prostatectomy ; robot-assisted
OBJECTIVE: To investigate the peri-operative and oncological outcomes of robot-assisted radical prostatectomy (RARP) in patients with oligometastatic prostate cancer (PCa). PATIENTS AND METHODS: We retrospectively reviewed the records of 79 patients with oligometastatic PCa treated with RARP or androgen deprivation therapy (ADT) between 2005 and 2015 at our institution. Of these 79 patients, 38 were treated with RARP and 41 were treated with ADT without local therapy. Oligometastatic disease was defined as the presence of five or fewer hot spots detected by preoperative bone scan. We evaluated peri-operative outcomes, progression-free survival (PFS), and cancer-specific survival (CSS). We analysed data using Kaplan-Meier methods, with log-rank tests and multivariate Cox regression models. RESULTS: Patients treated with RARP experienced similar postoperative complications to those previously reported in RP-treated patients, and fewer urinary complications than ADT-treated patients. PFS and CSS were longer in RARP-treated compared with ADT-treated patients (median PFS: 75 vs 28 months, P = 0.008; median CSS: not reached vs 40 months, P = 0.002). Multivariate analysis further identified RARP as a significant predictor of PFS and CSS (PFS: hazard ratio [HR] 0.388, P = 0.003; CSS: HR 0.264, P = 0.004). CONCLUSIONS: We showed that RARP in the setting of oligometastatic PCa is a safe and feasible procedure which improves oncological outcomes in terms of PFS and CSS. In addition, our data suggest that RARP effectively prevents urinary tract complications from PCa. The study highlights results from expert surgeons and highly selected patients that cannot be extrapolated to all patients with oligometastatic PCa; to confirm our findings, large, prospective, multicentre studies are required.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
김명수(Kim, Myung Soo)
나군호(Rha, Koon Ho) ORCID logo https://orcid.org/0000-0001-8588-7584
장원식(Jang, Won Sik) ORCID logo https://orcid.org/0000-0002-9082-0381
정원식(Jeong, Won Sik)
조강수(Cho, Kang Su) ORCID logo https://orcid.org/0000-0002-3500-8833
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
함원식(Ham, Won Sik) ORCID logo https://orcid.org/0000-0003-2246-8838
홍성준(Hong, Sung Joon) ORCID logo https://orcid.org/0000-0001-9869-065X
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