MP4-14 LONG-TERM CANCER CONTROL OUTCOMES IN PROSTATE CANCER (PCA) PATIENTS TREATED WITH ROBOTIC-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY (RALP): A MULTI-INSTITUTIONAL DATABASE ANALYSIS.

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History I1 Apr 2015MP4-14 LONG-TERM CANCER CONTROL OUTCOMES IN PROSTATE CANCER (PCA) PATIENTS TREATED WITH ROBOTIC-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY (RALP): A MULTI-INSTITUTIONAL DATABASE ANALYSIS. Firas Abdollah, Dane Klett, Akshay Sood, Jesse Sammon, Daniel Pucheril, Burkhard Beyer, Nicola Fossati, Giorgio Gandaglia, Craig Rogers, Hans Stricker, Wooju Jeong, James Peabody, Alexander Haese, Francesco Montorsi, Markus Graefen, Alberto Briganti, and Mani Menon Firas AbdollahFiras Abdollah More articles by this author , Dane KlettDane Klett More articles by this author , Akshay SoodAkshay Sood More articles by this author , Jesse SammonJesse Sammon More articles by this author , Daniel PucherilDaniel Pucheril More articles by this author , Burkhard BeyerBurkhard Beyer More articles by this author , Nicola FossatiNicola Fossati More articles by this author , Giorgio GandagliaGiorgio Gandaglia More articles by this author , Craig RogersCraig Rogers More articles by this author , Hans StrickerHans Stricker More articles by this author , Wooju JeongWooju Jeong More articles by this author , James PeabodyJames Peabody More articles by this author , Alexander HaeseAlexander Haese More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Markus GraefenMarkus Graefen More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , and Mani MenonMani Menon More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.157AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The last decade saw widespread dissemination of RALP as the preferred surgical method to treat clinically localized PCa. Most available data regarding cancer control outcomes are based on merely the surgical margin status and pathological stage at surgery. Indeed, long-term oncological follow-up data for RALP are still lacking. To address this void, we set to evaluate the biochemical recurrence (BCR)-free survival rate and clinical recurrence (CR)-free survival rate in a large multi-institutional database of PCa patients treated with RALP. METHODS 7105 patients who underwent RALP ± adjuvant treatment and pelvic node dissection between 2002–2013 at 3 tertiary care centers were included. All had complete baseline and follow-up data. BCR defined as PSA value ≥0.2 ng/ml on two consecutive occasions. Kaplan-Meier curves estimated 10-year BCR-free and CR-free survival rates. Cox logistic regression tested the relationship between baseline clinical and pathological characteristics (in 2 separate models) and 2 endpoints, namely post-op BCR rate, and post-op CR rate. RESULTS Mean (median) age and PSA at surgery were 60.6 (61) yrs and 6.6 (5.3) ng/ml, respectively. Most had a biopsy GS 2–6 (52.6%), clinical T1 stage (75.0%), D'Amico intermediate-risk disease (45.1%), pathological GS 7 (60.2%), and pathological T2 stage (55.8%). Overall, 23.5% and 3.1% respectively had positive surgical margins and lymph node invasion (LNI) at surgery. Only 2.2% received any adjuvant treatment. Mean (median) follow-up time was 49.4 (40.2) months. At 10-years, BCR-free survival rate was 72.7%, and it was 88.3, 66.5, and 50.4% in patients with respectively clinical low-, intermediate-, and high-risk disease according to D'Amico. Likewise, 10-year CR-free survival rate was 96.5%, and it was 99.9, 97.0, and 87.5% respectively in the aforementioned risk groups. At multivariable analysis (MVA), PSA, clinical stage and biopsy GS were independent predictors of both BCR and CR rates (all p<.01). Likewise, in a separate MVA model, PSA, pathological stage, pathological GS, margin status and LNI status were independent predictors of both BCR and CR rates (all p<0.02). CONCLUSIONS Our findings address the lack of literature regarding cancer control outcomes in pts treated with RALP. Given the very low use of adjuvant treatment in our cohort, our results represent the natural history of the disease from surgery to BCR. RALP appears to confer favorable cancer control long-term, comparable to open surgery. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e32 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Firas Abdollah More articles by this author Dane Klett More articles by this author Akshay Sood More articles by this author Jesse Sammon More articles by this author Daniel Pucheril More articles by this author Burkhard Beyer More articles by this author Nicola Fossati More articles by this author Giorgio Gandaglia More articles by this author Craig Rogers More articles by this author Hans Stricker More articles by this author Wooju Jeong More articles by this author James Peabody More articles by this author Alexander Haese More articles by this author Francesco Montorsi More articles by this author Markus Graefen More articles by this author Alberto Briganti More articles by this author Mani Menon More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...