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Can robot-assisted laparoscopic radical prostatectomy (RALP) be performed very soon after biopsy?

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Abstract

Purpose

To identify the perioperative and oncological impact of different intervals between biopsy and robot-assisted laparoscopic radical prostatectomy (RALP) for localized prostate cancer.

Methods

All consecutive patients with localized prostate cancer who underwent RALP with primary curative intent in January 2008–July 2014 in a large tertiary hospital were enrolled in this retrospective cohort study. The patients were divided into groups according to whether the biopsy–RALP interval was ≤2, ≤4, ≤6, or >6 weeks. Estimated blood loss and operating room time were surrogates for surgical difficulty. Surgical margin status and continence at the 1 year were surrogates for surgical efficacy. Biochemical recurrence (BCR) was defined as two consecutive postoperative prostate serum antigen values of ≥0.2 ng/ml.

Results

Of the 1446 enrolled patients, the biopsy–RALP interval was ≤2, ≤4, ≤6, and >6 weeks in 145 (10 %), 728 (50.3 %), 1124 (77.7 %), and 322 (22.3 %) patients, respectively. The >6 week group had a significantly longer mean operation time than the ≤2, ≤4, and ≤6 week groups. The groups did not differ significantly in terms of estimated blood loss or surgical margin status. Kaplan–Meier analysis showed that interval did not significantly affect postoperative BCR-free survival. Multivariable Cox proportional hazards model analysis showed that interval duration was not an independent predictor of BCR (≤2 vs. >2 weeks, HR = 0.859, p = 0.474; ≤4 vs. >4 weeks, HR = 1.029, p = 0.842; ≤6 vs. >6 weeks, HR = 0.84, p = 0.368).

Conclusion

Performing RALP within 2, 4, or 6 weeks of biopsy does not appear to adversely influence surgical difficulty or efficacy or oncological outcomes.

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Authors’ contribution

Jung Ki Jo developed the protocol/project, analyzed the data, and wrote the manuscript. Jong Jin Oh collected and managed the data. Sangchul Lee and Seong Jin Jeong analyzed the data. Sung Kyu Hong edited the manuscript. Seok-Soo Byun collected and managed the data, and edited the manuscript. Sang Eun Lee developed the protocol/project and edited the manuscript.

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Authors and Affiliations

  1. Department of Urology, Hanynag University College of Medicine, Seoul, Korea

    Jung Ki Jo

  2. Department of Urology, Seoul National University Bundang Hospital, 82, Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea

    Jong Jin Oh, Sangchul Lee, Seong Jin Jeong, Sung Kyu Hong, Seok-Soo Byun & Sang Eun Lee

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  1. Jung Ki Jo
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  2. Jong Jin Oh
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  3. Sangchul Lee
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Corresponding author

Correspondence to Sang Eun Lee.

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There are no conflicts of interest relevant to this article.

Ethical statement

This study was approved by Bundang Hospital institutional review board. Jung ki Jo and Sang Eun Lee participated in the project development. Jong Jin Oh and Seok-Soo Byun conducted data collection and management. Jung Ki Jo, Sangchul Lee and Seong Jin Jeong conducted data analysis. Jung Ki Jo conducted manuscript writing. Sung Kyu Hong, Seok-Soo Byun and Sang Eun Lee participated in manuscript editing. Our paper was proofread by Bioedit (www.bioedit.com).

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Jo, J.K., Oh, J.J., Lee, S. et al. Can robot-assisted laparoscopic radical prostatectomy (RALP) be performed very soon after biopsy?. World J Urol 35, 605–612 (2017). https://doi.org/10.1007/s00345-016-1893-4

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  • DOI: https://doi.org/10.1007/s00345-016-1893-4

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