BACKGROUND We aimed to assess the short-term oncological outcomes of robot-assisted laparoscopic radical prostatectomy to determine the predictive factors associated with biochemical recurrence in high-risk prostate cancer patients. METHODS A total of 331 patients with localized prostate cancer underwent robot-assisted laparoscopic radical prostatectomy. Of them, 113 patients were diagnosed with high-risk prostate cancer according to the D'Amico risk group classification. We evaluated the association between pre- or postoperative predictive factors and biochemical recurrence using Cox regression analysis. RESULTS The 2-year biochemical recurrence-free survival rate was 65.0% in the high-risk group. On univariate analyses, PSA level > 20 ng/mL, Gleason pattern 5 component on biopsy, pathological stage T3 or higher, perineural invasion, and positive surgical margin were predictive factors for biochemical recurrence. On multivariate analysis, PSA level > 20 ng/mL, Gleason pattern 5 component on biopsy, perineural invasion, and positive surgical margin were identified as independent predictive factors. The 2-year biochemical recurrence-free survival rate was 36.5% for patients with PSA level > 20 ng/mL and/or Gleason pattern 5 component on biopsy. CONCLUSIONS PSA level > 20 ng/mL and/or presence of the Gleason pattern 5 component on biopsy are predictive factors for early biochemical recurrence after robot-assisted laparoscopic radical prostatectomy in high-risk prostate cancer patients. We considered that these patients require a combined modality therapy to improve their prognosis.

中文翻译：

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高危前列腺癌患者机器人辅助腹腔镜根治性前列腺切除术后短期生化无复发生存的预测因素。

背景技术我们旨在评估机器人辅助腹腔镜前列腺癌根治术的近期肿瘤学结果，以确定与高危前列腺癌患者生化复发相关的预测因素。方法331例局限性前列腺癌患者接受了机器人辅助的腹腔镜前列腺癌根治术。根据D'Amico风险组分类，其中113例患者被诊断为高危前列腺癌。我们使用Cox回归分析评估了术前或术后预测因素与生化复发之间的关联。结果高危组的2年生化无复发生存率为65.0％。单因素分析时，PSA水平> 20 ng / mL，活检的Gleason模式5成分，病理分期T3或更高，神经周浸润，和手术切缘阳性是生化复发的预测因素。在多变量分析中，PSA水平> 20 ng / mL，活检的Gleason模式5成分，神经周围浸润和手术切缘阳性被确定为独立的预测因素。PSA水平> 20 ng / mL和/或Gleason pattern 5成分经活检的患者的2年生化无复发生存率为36.5％。结论PSA> 20 ng / mL和/或活检中存在Gleason pattern 5成分是机器人辅助高危前列腺癌患者腹腔镜根治性前列腺切除术后早期生化复发的预测因素。我们认为这些患者需要联合模态疗法以改善其预后。在多变量分析中，PSA水平> 20 ng / mL，活检的Gleason模式5成分，神经周围浸润和手术切缘阳性被确定为独立的预测因素。PSA水平> 20 ng / mL和/或Gleason pattern 5成分经活检的患者2年无生化复发生存率为36.5％。结论PSA> 20 ng / mL和/或活检中存在Gleason pattern 5成分是机器人辅助高危前列腺癌患者腹腔镜根治性前列腺切除术后早期生化复发的预测因素。我们认为这些患者需要联合模态疗法以改善其预后。在多变量分析中，PSA水平> 20 ng / mL，活检的Gleason模式5成分，神经周浸润和手术切缘阳性被确定为独立的预测因素。PSA水平> 20 ng / mL和/或Gleason pattern 5成分经活检的患者的两年生化无复发生存率为36.5％。结论PSA> 20 ng / mL和/或活检中存在Gleason pattern 5成分是机器人辅助高危前列腺癌患者腹腔镜根治性前列腺切除术后早期生化复发的预测因素。我们认为这些患者需要联合模态疗法以改善其预后。手术切缘和阳性边缘被确定为独立的预测因素。PSA水平> 20 ng / mL和/或Gleason pattern 5成分经活检的患者的两年生化无复发生存率为36.5％。结论PSA> 20 ng / mL和/或活检中存在Gleason pattern 5成分是机器人辅助高危前列腺癌患者腹腔镜根治性前列腺切除术后早期生化复发的预测因素。我们认为这些患者需要联合模态疗法以改善其预后。手术切缘和阳性边缘被确定为独立的预测因素。PSA水平> 20 ng / mL和/或Gleason pattern 5成分经活检的患者的两年生化无复发生存率为36.5％。结论PSA> 20 ng / mL和/或活检中存在Gleason pattern 5成分是机器人辅助高危前列腺癌患者腹腔镜根治性前列腺切除术后早期生化复发的预测因素。我们认为这些患者需要联合模态疗法以改善其预后。活检中20 ng / mL和/或格里森5型成分的存在是高危前列腺癌患者机器人辅助腹腔镜根治性前列腺切除术后早期生化复发的预测因素。我们认为这些患者需要联合模态疗法以改善其预后。活检中20 ng / mL和/或格里森5型成分的存在是高危前列腺癌患者机器人辅助腹腔镜根治性前列腺切除术后早期生化复发的预测因素。我们认为这些患者需要联合模态疗法以改善其预后。