Predictive factors for short-term biochemical recurrence-free survival after robot-assisted laparoscopic radical prostatectomy in high-risk prostate cancer patients
- 41 Downloads
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.
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.
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.
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.
KeywordsGleason pattern Prostate cancer Prostatectomy Prostate-specific antigen Regression analysis
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.
- 19.Kattan MW (2003) Nomograms are superior to staging and risk grouping systems for identifying high-risk patients: preoperative application in prostate cancer. Urology 13:111–116Google Scholar
- 29.Meng Y, Liao YB, Xu P et al (2015) Perineural invasion is an independent predictor of biochemical recurrence of prostate cancer after local treatment: a meta-analysis. Int J Clin Exp Med 8:13267–13274Google Scholar