Comparative analysis of oncologic outcomes for open vs. robot-assisted radical prostatectomy in high-risk prostate cancer
Korean Journal of Urology
;
: 572-579, 2015.
Article
Dans Anglais
| WPRIM
| ID: wpr-65717
ABSTRACT
PURPOSE:
To evaluate the oncologic outcomes of robot-assisted radical prostatectomy (RARP) in high-risk prostate cancer (PCa), we compared the surgical margin status and biochemical recurrence-free survival (BCRFS) rates between retropubic radical prostatectomy (RRP) and RARP. MATERIALS ANDMETHODS:
A comparative analysis was conducted of high-risk PCa patients who underwent RRP or RARP by a single surgeon from 2007 to 2013. High-risk PCa was defined as clinical stage> or =T3a, biopsy Gleason score 8-10, or prostate-specific antigen>20 ng/mL. Propensity score matching was performed to minimize selection bias, and all possible preoperative and postoperative confounders were matched. A Kaplan-Meier analysis was performed to assess the 5-year BCRFS, and Cox regression models were used to evaluate the effect of the surgical approach on biochemical recurrence.RESULTS:
A total of 356 high-risk PCa patients (106 [29.8%] RRP and 250 [70.2%] RARP) were included in the final cohort analyzed. Before adjustment, the mean percentage of positive cores on biopsy and pathologic stage were poorer for RRP versus RARP (p=0.036 vs. p=0.054, respectively). The unadjusted 5-year BCRFS rates were better for RARP than for RRP (RRP vs. RARP 48.1% vs. 64.4%, p=0.021). After adjustment for preoperative variables, the 5-year BCRFS rates were similar between RRP and RARP patients (48.5% vs. 59.6%, p=0.131). The surgical approach did not predict biochemical recurrence in multivariate analysis.CONCLUSIONS:
Five-year BCRFS rates of RARP are comparable to RRP in high-risk PCa. RARP is a feasible treatment option for high-risk PCa.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Prostatectomie
/
Tumeurs de la prostate
/
Bases de données factuelles
/
Résultat thérapeutique
/
Estimation de Kaplan-Meier
/
Grading des tumeurs
/
Interventions chirurgicales robotisées
/
Métastase lymphatique
/
Stadification tumorale
Type d'étude:
Etude d'étiologie
/
Étude pronostique
Limites du sujet:
Adulte très âgé
/
Humains
/
Mâle
langue:
Anglais
Texte intégral:
Korean Journal of Urology
Année:
2015
Type:
Article
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