title: Risk stratification and early oncologic outcomes following robotic prostatectomy.
abstract: OBJECTIVE
  Although the popularity of robotic-assisted laparoscopic prostatectomy is assured, little is known about the oncologic outcomes following the procedure.
  
  
  METHODS
  We performed a retrospective cohort study including consecutive patients who underwent the surgery between 2003 and 2007 with at least 6 months of follow-up (n=464). Patients were stratified into low-, intermediate-, and high-risk groups according to D'Amico criteria. Biochemical failure was defined as a PSA > or =0.2 ng/mL.
  
  
  RESULTS
  Of study patients, 256 (55%), 171 (37%), and 37 (8%) were classified as low-, intermediate-, and high-risk, respectively. Over a mean follow-up of 14.1 months (range, 6.0 to 55.3), 7.3% experienced biochemical failure. Biochemical disease-free survival at 30 months was 94%, 79%, and 73% among patients in the low-, intermediate-, and high-risk groups, respectively, (P<0.001). Preoperative risk stratification was strongly associated with biochemical failure, with hazard ratios of 5.04 (95%: 1.52 to 16.7; P<0.001) and 7.04 (95%: 1.39 to 35.6; P < 0.001) for intermediate- and high- over low-risk groups, respectively. The ability of risk stratification to predict biochemical failure had an area under the receiver operator characteristic curve of 0.74.
  
  
  CONCLUSIONS
  Robotic prostatectomy provides excellent cancer control outcomes for clinically localized disease.
authors.affiliation: Mount Sinai Medical Center, New York, New York 10022, USA.
authors.forename: Ardavan
authors.initials: A
authors.lastname: Akhavan
authors.forename: Adam W
authors.initials: AW
authors.lastname: Levinson
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Fatima
authors.initials: F
authors.lastname: Nabizada-Pace
authors.forename: David B
authors.initials: DB
authors.lastname: Samadi
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D012371:Robotics; D012680:Sensitivity and Specificity; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen