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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Urology 1/2015

Risk factors for biochemical recurrence after robotic assisted radical prostatectomy: a single surgeon experience

Zeitschrift:
BMC Urology > Ausgabe 1/2015
Autoren:
Ryuta Tanimoto, Yomi Fashola, Kymora B Scotland, Anne E Calvaresi, Leonard G Gomella, Edouard J Trabulsi, Costas D Lallas
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12894-015-0024-7) contains supplementary material, which is available to authorized users.

Competing interests

Drs. Ryuta Tanimoto, Yomi Fashola, Kymora B. Anne E. Calvaresi, CRNP, Scotland, Edouard J. Trabulsi, Costas D. Lallas declare no conflict of interest or financial ties. Dr. Leonard G. Gomella declares the following conflict of interest; a consultant to Astellas, Bayer, Dendreon and Janssen, and the research funding from Astellas and FSK.

Authors’ contributions

RT, CDL, LGG and EJT designed the study. RT, AEC and YF wrote the manuscript and obtained infromation from charts. CDL and EJT performed the pathological review, RT performed the statistical analysis. RT, KBS, AEC, CDL and EJT reviewed and edited the manuscript. All authors read and approved the final manuscript.

Abstract

Background

Radical prostatectomy is a standard surgical treatment of clinically localized prostate cancer. Margin status has been found to be an independent predictor of biochemical recurrence (BCR) after open radical prostatectomy in several large series but this is still controversy in Robotic Assisted Radical Prostatectomy (RARP) series. We therefore wanted to investigate the prognostic significance of positive surgical margin (PSM) and other pathological factors on BCR in patients treated with RARP by a single surgeon.

Methods

Prospectively collected data of 439 patients treated with RARP between October 2005 and June 2013 by a single surgeon at a single institution were analyzed. BCR was defined as follow-up PSA level > 0.2 ng/ml on two separate occasions or patients who had to undergo salvage therapy. Kaplan Meier curves and Log Rank test were used to compare the risk of BCR. Univariate and Multivariate Cox Regression analyses were performed to determine the prognostic impact of age, BMI, prostate weight, PSA prior to surgery, pathological T-stage, pathological Gleason sum, PSM and operative period.

Results

In this study period, 34 out of 439 had BCR, giving an overall BCR rate of 7.7% for this cohort. Overall 2- and 3-year BCR-free survival rates were 93% and 88%, respectively. Patients with a PSM had a 2-year BCR free survival of 88% compared to 94% in those with negative margins (p < .0001). On the multivariate analysis, PSM as well as pathological Gleason sum > = 8, PSA, pathological stage and operative period were significantly associated with BCR.

Conclusions

In our case series of RARP performed by a single surgeon, PSM as well as pathological Gleason sum, PSA, pathological stage and early operative period for this surgeon were the independent predictors of BCR.
Zusatzmaterial
Additional file 1: Table S1. The margin location in the patients with positive surgical margins (n=119).
12894_2015_24_MOESM1_ESM.xlsx
Additional file 2: Table S2. The positive surgical margin rate for each pathological stage over time.
12894_2015_24_MOESM2_ESM.xlsx
Literatur
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