PD27-07 IMPACT OF SURGICAL TECHNIQUE ON THE RISK OF BIOCHEMICAL RECURRENCE IN PATIENTS WITH INTERMEDIATE AND HIGH-RISK PROSTATE CANCER TREATED WITH RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced I1 Apr 2014PD27-07 IMPACT OF SURGICAL TECHNIQUE ON THE RISK OF BIOCHEMICAL RECURRENCE IN PATIENTS WITH INTERMEDIATE AND HIGH-RISK PROSTATE CANCER TREATED WITH RADICAL PROSTATECTOMY Giorgio Gandaglia, Marco Bianchi, Nazareno Suardi, Andrea Gallina, Umberto Capitanio, Andrea Salonia, Emanuele Zaffuto, Rocco Damiano, Francesco Cantiello, Pierre I. Karakiewicz, Maxine Sun, Shahrokh F. Shariat, Francesco Montorsi, and Alberto Briganti Giorgio GandagliaGiorgio Gandaglia More articles by this author , Marco BianchiMarco Bianchi More articles by this author , Nazareno SuardiNazareno Suardi More articles by this author , Andrea GallinaAndrea Gallina More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Emanuele ZaffutoEmanuele Zaffuto More articles by this author , Rocco DamianoRocco Damiano More articles by this author , Francesco CantielloFrancesco Cantiello More articles by this author , Pierre I. KarakiewiczPierre I. Karakiewicz More articles by this author , Maxine SunMaxine Sun More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2106AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The oncological safety of robot-assisted (RARP) and open radical prostatectomy (ORP) in patients with more aggressive disease is still debated. We aimed at comparing the biochemical recurrence (BCR) rates of RARP and ORP in patients with intermediate or high-risk prostate cancer (PCa). Additionally, since individuals experiencing early BCR are at increased risk of clinical progression and cancer-specific mortality, we assessed the impact of the surgical approach also on the risk of early BCR. METHODS Overall, 2,181 patients with intermediate or high-risk PCa (clinical stage ≥T2b, biopsy Gleason score (GS) ≥7, and/or preoperative PSA ≥10ng/ml) treated at a single tertiary referral center between January 2006 and August 2013 were identified. No patient received neo-adjuvant or adjuvant therapies. BCR was defined as the detection of PSA ≤0.2ng/ml after surgery. Early BCR was defined as the occurrence of BCR within 2 years from surgery. Uni- and multivariable (MVA) Cox regression analyses evaluated the association between the surgical approach and the risk of BCR and early BCR, after accounting for confounders. Covariates consisted of clinical stage, biopsy GS, and preoperative PSA. Subsequently, we evaluated the impact of RARP on the risk of BCR and early BCR after accounting for pathological GS, pathological stage, surgical margin status (SM), and adjuvant treatments. RESULTS Mean patient age was 64.9 years (median: 65). Overall, 1,522 (69.8%) and 659 (30.2%) patients were treated with ORP and RARP, respectively. Overall, the 5-year BCR-free survival rates were 79.8%. The 5-year BCR-free survival rates were 79.8% and 81.9% in patients treated with ORP and RARP, respectively (P=0.7). At univariable Cox regression analysis, RARP was not associated with increased risk of BCR (Odds ratio [OR]: 1.27; 95% confidence interval [CI]: 0.72-1.58; P=0.3) and early BCR (OR: 1.07; 95% CI: 0.78-2.06; P=0.7). This was confirmed at MVA, where RARP was not associated with BCR and early BCR, after accounting both for preoperative (PSA, clinical stage, and biopsy GS) and postoperative (pathological stage, pathological GS, SM, lymph node invasion, and adjuvant treatments) confounders (all P>0.1). CONCLUSIONS RARP and ORP have comparable 5-year BCR-free survival rates in patients with intermediate- and high-risk PCa. Minimally invasive approach leads to comparable oncological outcomes in terms of BCR and early BCR. These results support the oncological safety of RARP in patients with intermediate- and high-risk PCa. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e767 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Giorgio Gandaglia More articles by this author Marco Bianchi More articles by this author Nazareno Suardi More articles by this author Andrea Gallina More articles by this author Umberto Capitanio More articles by this author Andrea Salonia More articles by this author Emanuele Zaffuto More articles by this author Rocco Damiano More articles by this author Francesco Cantiello More articles by this author Pierre I. Karakiewicz More articles by this author Maxine Sun More articles by this author Shahrokh F. Shariat More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...