MP57-15 COMPARISON OF BIOCHEMICAL RECURRENCE-FREE SURVIVAL BETWEEN ROBOTIC-ASSISTED RADICAL PROSTATECTOMY AND RETROPUBIC RADICAL PROSTATECTOMY: A PROPENSITY SCORE MATCHING ANALYSIS

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy III1 Apr 2016MP57-15 COMPARISON OF BIOCHEMICAL RECURRENCE-FREE SURVIVAL BETWEEN ROBOTIC-ASSISTED RADICAL PROSTATECTOMY AND RETROPUBIC RADICAL PROSTATECTOMY: A PROPENSITY SCORE MATCHING ANALYSIS Yosuke Hirasawa, Makoto Ohori, Kenji Shimodaira, Takeshi Kashima, Tatsuo Gondo, Yoshihiro Nakagami, Yutaka Horiguchi, Yoshio Ohno, Kazunori Namiki, Kunihiko Yoshioka, Jun Nakashima, and Masaaki Tachibana Yosuke HirasawaYosuke Hirasawa More articles by this author , Makoto OhoriMakoto Ohori More articles by this author , Kenji ShimodairaKenji Shimodaira More articles by this author , Takeshi KashimaTakeshi Kashima More articles by this author , Tatsuo GondoTatsuo Gondo More articles by this author , Yoshihiro NakagamiYoshihiro Nakagami More articles by this author , Yutaka HoriguchiYutaka Horiguchi More articles by this author , Yoshio OhnoYoshio Ohno More articles by this author , Kazunori NamikiKazunori Namiki More articles by this author , Kunihiko YoshiokaKunihiko Yoshioka More articles by this author , Jun NakashimaJun Nakashima More articles by this author , and Masaaki TachibanaMasaaki Tachibana More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.669AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To investigate a single institution experience with retropubic radical prostatectomy (RRP) and robot-assisted radical prostatectomy (RARP) with respect to biochemical recurrence free survival (BCRFS). METHODS We studied the 918 patients treated with radical prostatectomy (RARP, n=582 and RRP, n=336) for T1-3N0M0 prostate cancer between 2000 and 2012. Men treated with neoadjuvant hormonal therapy were excluded from the analysis. Clinical and pathological features were compared between the 2 groups. In this group, 269 consecutive patients treated with RRP between 2000 and 2010 were matched by propensity scoring on the based on patient age, preoperative PSA level, pathological Gleason score, extracapsular extension, seminal invasion and positive surgical margin with an equal number of patients who underwent RARP between 2006 and 2012 to minimize treatment selection biases. RESULTS The median follow-up periods in the RARP and RRP groups were 42.4 months (range, 6.5-105) / 82 months (6.8-163), respectively. The median preoperative PSA level in the RARP and RRP were 6.8 ng/mL (3-44.7) and 7.4 ng/mL (1.1-89), respectively (p<0.001). The proportions of patients with pathological T2 and T3 disease were 71.5% and 27.1% in the RARP group and 59.8% and 38.4% in the RRP group, respectively (p=0.0037). The 5-year BCRFS of the RARP group was 82+1.9% which was significant higher than that (60.1+2.8%) in the of RRP group (p<0.001). For patients without positive surgical margins, the 5-year BCRFS of the RARP (n=409) and RRP groups (n=161) were 87.8% and 77.5%, respectively (p<0.001). In the 269 patients who were matched based on the propensity scores by using 6 factors, the propensity adjusted 5-year BCRFS of the RARP group was 75.5+2.9% which was significantly better than that (62.5%+3.0%) of the RRP group (p=0.0028). Similarly, the propensity-adjusted 5-year BCRFS of the low-, intermediate-, and high- risk patients in the RARP and RRP groups were 93% and 79.9%(p=0.12), 80.3% and 68.1%(p=0.043), and 59.6% and 41.6% (p=0.017), respectively. CONCLUSIONS We observed that the BCRFS rates of patients with intermediate-, and high-risk was statistically superior when these patients underwent RARP than they underwent RRP. This difference may not be easy to be explained based only on the standard pathological outcomes: thus, more-detailed analyses of the degree and location of positive surgical and/or benign tissue margins may be needed. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e758-e759 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Yosuke Hirasawa More articles by this author Makoto Ohori More articles by this author Kenji Shimodaira More articles by this author Takeshi Kashima More articles by this author Tatsuo Gondo More articles by this author Yoshihiro Nakagami More articles by this author Yutaka Horiguchi More articles by this author Yoshio Ohno More articles by this author Kazunori Namiki More articles by this author Kunihiko Yoshioka More articles by this author Jun Nakashima More articles by this author Masaaki Tachibana More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...