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Predictive factors for short-term biochemical recurrence-free survival after robot-assisted laparoscopic radical prostatectomy in high-risk prostate cancer patients

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Abstract

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.

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Acknowledgements

The authors thank the nursing and anesthesia staff at Iwate Medical University Hospital.

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Authors and Affiliations

  1. Department of Urology, Iwate Medical University Hospital, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan

    Mitsugu Kanehira, Ryo Takata, Shuhei Ishii, Akito Ito, Daiki Ikarashi, Tomohiko Matsuura, Yoichiro Kato & Wataru Obara

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  1. Mitsugu Kanehira
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  2. Ryo Takata
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  3. Shuhei Ishii
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  4. Akito Ito
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  5. Daiki Ikarashi
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  7. Yoichiro Kato
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  8. Wataru Obara
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Correspondence to Mitsugu Kanehira.

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10147_2019_1445_MOESM1_ESM.jpg

Supplementary material 1 (JPEG 28 kb) Kaplan–Meier analysis of the BCR-free survival rates between the initial cases and the subsequent cases. The initial cases were defined as the first 20 cases treated by each surgeon (80 cases in total)

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Kanehira, M., Takata, R., Ishii, S. et al. Predictive factors for short-term biochemical recurrence-free survival after robot-assisted laparoscopic radical prostatectomy in high-risk prostate cancer patients. Int J Clin Oncol 24, 1099–1104 (2019). https://doi.org/10.1007/s10147-019-01445-7

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  • DOI: https://doi.org/10.1007/s10147-019-01445-7

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