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Predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy: Analysis of 359 cases with a median follow-up period of 26 months

Authors
 Ali Abdel Raheem  ;  Ki Don Chang  ;  Mohammed Jayed Alenzi  ;  Won Sik Ham  ;  Woong Kyu Han  ;  Young Deuk Choi  ;  Koon Ho Rha 
Citation
 International Journal of Urology, Vol.25(12) : 1006-1014, 2018 
Journal Title
 International Journal of Urology 
ISSN
 0919-8172 
Issue Date
2018
Keywords
Retzius-sparing ; biochemical recurrence ; prostate cancer
Abstract
OBJECTIVES: Our aim was to evaluate the predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy. METHODS: The study cohort consisted of 359 consecutive non-metastatic prostate cancer patients who underwent Retzius-sparing robot-assisted radical prostatectomy between November 2012 and January 2016. According to the National Comprehensive Cancer Network prostate cancer risk classification, 164 patients (45.7%) had high- or very high-risk prostate cancer. No patient received adjuvant therapy until documented biochemical recurrence. Biochemical recurrence-free survival was estimated using the Kaplan-Meier method. Univariable and multivariable Cox proportional hazards regression models were used to determine variables predictive of biochemical recurrence. RESULTS: The median follow-up period was 26 months (interquartile range 19-38 months). The overall biochemical recurrence rate was 14.8%, and the median time to biochemical recurrence was 11 months (interquartile range 6-22 months). The 3-year biochemical recurrence-free survival probability was 71.2%, 72.1%, 88.7%, 82.3% and 95.7% in very high-, high-, intermediate-, low- and very low-risk prostate cancer, respectively (log-rank, P < 0.001). On multivariable analysis, preoperative prostate-specific antigen (hazard ratio 1.03, 95% confidence interval 1.02-1.04; P < 0.0001), percentage of maximum core involvement on biopsy (hazard ratio 1.02, 95% confidence interval 1.01-1.03; P = 0.029) and clinical stage ≥T3a (hazard ratio 2.12, 95% confidence interval 1.02-4.39; P = 0.043) were predictors of biochemical recurrence, whereas pathological Gleason score ≥8 (hazard ratio 5.63, 95% confidence interval 1.62-19.61; P = 0.007) and pathological tumor volume (hazard ratio 1.08, 95% confidence interval 1.04-1.20; P < 0.001) were the main pathological predictors of biochemical recurrence. CONCLUSIONS: Retzius-sparing robot-assisted radical prostatectomy confers effective biochemical recurrence control at the mid-term follow-up period. Preoperative prostate-specific antigen, advanced clinical stage and higher Gleason score were important predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy. Long-term oncological safety still needs to be established.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1111/iju.13808
DOI
10.1111/iju.13808
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
나군호(Rha, Koon Ho) ORCID logo https://orcid.org/0000-0001-8588-7584
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
한웅규(Han, Woong Kyu) ORCID logo https://orcid.org/0000-0002-2527-4046
함원식(Ham, Won Sik) ORCID logo https://orcid.org/0000-0003-2246-8838
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/167306
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