You have accessJournal of UrologyProstate Cancer: Advanced II1 Apr 2015MP82-16 LONG-TERM CLINICAL RECURRENCE RATE IN PROSTATE CANCER (PCA) PATIENTS WITH ADVERSE PATHOLOGICAL CHARACTERISTICS AT ROBOTIC-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY (RALP) Firas Abdollah, Akshay Sood, Dane Klett, Jesse Sammon, Daniel Pucheril, Burkhard Beyer, Nicola Fossati, Giorgio Gandaglia, Nazareno Suardi, Craig Rogers, Wooju Jeong, James Peabody, Alexander Haese, Francesco Montorsi, Markus Graefen, Alberto Briganti, and Mani Menon Firas AbdollahFiras Abdollah More articles by this author , Akshay SoodAkshay Sood More articles by this author , Dane KlettDane Klett 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 , Nazareno SuardiNazareno Suardi More articles by this author , Craig RogersCraig Rogers 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.2015.02.535AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite widespread use of RALP, little is known about its oncological outcomes. This is specifically true for men with adverse pathological characteristics at surgery. To address this void, we set to evaluate long-term CR rate in these men, and to develop a novel nomogram predicting long-term CR in these individuals. METHODS We focused on 2476 men treated with RALP and pelvic node dissection ± adjuvant treatment, between 2002 and 2013, at 3 tertiary care centers. All men had complete follow-up data and had adverse pathological characteristics at RALP, defined as pT3a stage disease or higher, and/or positive surgical margin (SM). Uni- and multi-variable (MVA) Cox regression analyses were used to test the relationship between all available predictors, and CR after RALP. Covariates consisted of age, PSA, pathological stage, pathological Gleason score (pGS), SM status, and lymph node invasion (LNI) status. A nomogram was developed based on the independent predictors of CR. This novel tool was internally validated using 200-bootstraping method. RESULTS Mean (median) PSA at surgery was 8.4 (6.0) ng/ml. Most patients had pT3a stage disease (65.9%), and pGS of 7 (71.0%). Overall, 55.2% and 9.1% of patients had positive SM, and LNI, respectively. Adjuvant treatment, and salvage treatment were administrated to 5.5%, and 19.7% of patients, respectively. Mean (median) follow-up time was 48.5 (40.9) months. At 5- and 10-year the CR-free survival rate was 95.9% and 90.0%, respectively. At MVA, higher PSA (HR: 1.02), pathological pT3b/pT4 stage (HR: 3.4), pGS 8-10 (HRs: 9.9), positive SM (HR: 2.1), and LNI (HR: 2.3) were independent predictors of less favorable CR rate (all p≤0.02). These variables were used to develop a new nomogram (Fig.) that had a favorable discrimination (85%), and calibration characteristics. CONCLUSIONS RALP has very favorable cancer control outcomes, despite adverse pathological characteristics at surgery. We present the first nomogram predicting CR risk in men with pathologically advanced PCa at RALP. This novel tool has very good performance characteristics. Thus, it can be used to advice patients about their prognosis, and to decide the necessity of a multimodal treatment approach after RALP. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1043 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Firas Abdollah More articles by this author Akshay Sood More articles by this author Dane Klett 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 Nazareno Suardi More articles by this author Craig Rogers 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 ...