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Predictive factors for short-term biochemical recurrence-free survival after robot-assisted laparoscopic radical prostatectomy in high-risk prostate cancer patients

  • Mitsugu KanehiraEmail author
  • Ryo Takata
  • Shuhei Ishii
  • Akito Ito
  • Daiki Ikarashi
  • Tomohiko Matsuura
  • Yoichiro Kato
  • Wataru Obara
Original Article
  • 41 Downloads

Abstract

Background

We aimed to assess the short-term oncological outcomes of robot-assisted laparoscopic radical prostatectomy to determine the predictive factors associated with biochemical recurrence in high-risk prostate cancer patients.

Methods

A total of 331 patients with localized prostate cancer underwent robot-assisted laparoscopic radical prostatectomy. Of them, 113 patients were diagnosed with high-risk prostate cancer according to the D’Amico risk group classification. We evaluated the association between pre- or postoperative predictive factors and biochemical recurrence using Cox regression analysis.

Results

The 2-year biochemical recurrence-free survival rate was 65.0% in the high-risk group. On univariate analyses, PSA level > 20 ng/mL, Gleason pattern 5 component on biopsy, pathological stage T3 or higher, perineural invasion, and positive surgical margin were predictive factors for biochemical recurrence. On multivariate analysis, PSA level > 20 ng/mL, Gleason pattern 5 component on biopsy, perineural invasion, and positive surgical margin were identified as independent predictive factors. The 2-year biochemical recurrence-free survival rate was 36.5% for patients with PSA level > 20 ng/mL and/or Gleason pattern 5 component on biopsy.

Conclusions

PSA level > 20 ng/mL and/or presence of the Gleason pattern 5 component on biopsy are predictive factors for early biochemical recurrence after robot-assisted laparoscopic radical prostatectomy in high-risk prostate cancer patients. We considered that these patients require a combined modality therapy to improve their prognosis.

Keywords

Gleason pattern Prostate cancer Prostatectomy Prostate-specific antigen Regression analysis 

Notes

Acknowledgements

The authors thank the nursing and anesthesia staff at Iwate Medical University Hospital.

Compliance with ethical standards

Conflict of interest

We have no conflict of interest to declare.

Supplementary material

10147_2019_1445_MOESM1_ESM.jpg (28 kb)
Supplementary material 1 (JPEG 28 kb) Kaplan–Meier analysis of the BCR-free survival rates between the initial cases and the subsequent cases. The initial cases were defined as the first 20 cases treated by each surgeon (80 cases in total)

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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  1. 1.Department of UrologyIwate Medical University HospitalMoriokaJapan

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