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Long-term oncologic outcomes of robot-assisted versus open radical prostatectomy for prostate cancer with seminal vesicle invasion: a multi-institutional study with a minimum 5-year follow-up

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Purpose

This study aimed to compare the long-term oncological outcomes of robot-assisted radical prostatectomy (RARP) vs. open radical prostatectomy (ORP) in pathologically proven prostate cancer with seminal vesicle invasion (SVI).

Methods

We performed a cohort study involving men who underwent radical prostatectomy for prostate cancer with SVI. We adjusted the confounders for RARP versus open surgery using the stabilized inverted probability of treatment weighting. Multivariable survival regression analysis was used to compare the treatment effect of RARP vs. ORP on biochemical recurrence (BCR) and clinical progression (CP).

Results

Between January 2000 and December 2012, 272 of 510 men (53.3%) underwent RARP at four tertiary hospitals in Korea. The median follow-up in the entire cohort was 75.7 months (interquartile range, 58.9–96.6 months). Among 389 BCR events, 205 (75.4%) and 184 (77.3%) occurred in the robot-assisted and open groups, respectively. The 5-year BCR-free survival was 22.2% and 20.5% among men who underwent RARP and ORP, respectively (hazard ratio (HR) 0.90; 95% confidence interval (CI), 0.73–1.10; P = 0.29 by the log-rank test). Ninety-nine patients experienced CP (55 and 44 in the RARP and open groups, respectively), representing Kaplan–Meier estimated 5-year event-free rates of 82.1% and 86.1% in the RARP and open groups, respectively, (HR 1.20; 95% CI 0.80–1.79; P = 0.39).

Conclusion

The long-term outcomes of RARP for prostate cancer with SVI were comparable to those of open surgery in this large multi-institutional study. However, this result should be confirmed by well-designed prospective randomized controlled trials.

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Acknowledgements

Author affiliations: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (J Suh, IG Jeong, and H Ahn); Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (HG Jeon and SS Jeon); Department of Urology, Seoul National University Hospital, Seoul, Korea (CW Jeong and C Kwak); Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea (S Lee and SS Byun).

Funding

This study was supported by the Korean Urologic Oncologic Society.

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Authors and Affiliations

  1. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Jungyo Suh, In Gab Jeong & Hanjong Ahn

  2. Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Hwang Gyun Jeon & Seong Soo Jeon

  3. Department of Urology, Seoul National University Hospital, Seoul, Korea

    Chang Wook Jeong & Cheol Kwak

  4. Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea

    Sangchul Lee & Seok Soo Byun

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  1. Jungyo Suh
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  2. In Gab Jeong
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Contributions

Dr. IGJ and HA had full access to all of the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. Study concept and design: IGJ and HA. Acquisition, analysis, or interpretation of data: all authors. Drafting of the manuscript: JS and IGJ. Statistical analysis: JS and IGJ. Administrative, technical, and material support: all authors. Study supervision: IGJ and HA.

Corresponding authors

Correspondence to In Gab Jeong or Hanjong Ahn.

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The authors declare that they have no conflict of interest.

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The requirement for patient informed consent was waived by the Institutional Review Board of Asan Medical Center.

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All patients whose data were retrospectively analyzed were informed of the use of their clinical information under anonymization and received an opportunity to object to use or publication.

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Suh, J., Jeong, I.G., Jeon, H.G. et al. Long-term oncologic outcomes of robot-assisted versus open radical prostatectomy for prostate cancer with seminal vesicle invasion: a multi-institutional study with a minimum 5-year follow-up. J Cancer Res Clin Oncol 149, 1951–1960 (2023). https://doi.org/10.1007/s00432-022-04243-3

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