Oncologic outcome of robot-assisted laparoscopic prostatectomy in the high-risk setting

Jason D. Engel, William W. Kao, Stephen Williams, Y. Mark Hong

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background and Purpose: Previous studies have demonstrated the feasibility of open radical prostatectomy in the high-risk setting. Management of high-risk disease with robot-assisted laparoscopic radical prostatectomy (RALP) is controversial. We examined biochemical recurrence in a selected cohort of high-risk patients who were undergoing RALP. Patients and Methods: Men with high-risk prostate cancer who underwent bilateral nerve-sparing, nonsalvage RALP by a single surgeon without adjuvant or neoadjuvant therapy of any kind were identified. High risk was defined by preoperative prostate-specific antigen (PSA) level >10ng/dL, Gleason score ≥8 on final pathologic evaluation, or stage ≥pT3. Postoperative PSA value ≥0.2ng/dL defined biochemical recurrence. Results: A total of 73 men were identified. There was no significant difference in surgical margin positivity (38% overall) or prostate size between recurrence and nonrecurrence cohorts. Biochemical failure was significantly associated with higher pathologic Gleason score (P=0.0085) but not pathologic stage (P=0.22) or preoperative PSA level (P=0.18). With follow-up to 85 months (mean 31.8 mos), biochemical recurrence-free survival was 77% with mean time to recurrence of 7.7 months. Recurrence occurred significantly earlier than later (P

Original languageEnglish (US)
Pages (from-to)1963-1966
Number of pages4
JournalJournal of Endourology
Volume24
Issue number12
DOIs
StatePublished - Dec 1 2010
Externally publishedYes

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ASJC Scopus subject areas

  • Urology

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