title: Long-term biochemical recurrence rates after robot-assisted radical prostatectomy: analysis of a single-center series of patients with a minimum follow-up of 5 years.
abstract: OBJECTIVE
  To address the long-term biochemical recurrence (BCR)-free survival rates of patients treated with robotic-assisted laparoscopic prostatectomy (RALP) with a minimum follow-up of 5 years.
  
  
  METHODS
  Prospectively collected data of 184 patients treated with RALP at a single institution were analyzed. Kaplan-Meier and life tables analyses targeted the rates of BCR according to pathologic parameters. Cox regression analyses addressed predictors of BCR.
  
  
  RESULTS
  Median follow-up was 67.5 months. One and 10 patients died of prostate cancer (PCa) and other causes, respectively. Mean time to BCR was 83.8 months. The 3-, 5-, and 7-year BCR-free survival rates were 94%, 86%, and 81%, respectively. These rates were 97%, 93%, and 85% for pT2 disease; 94%, 84%, and 84% for pT3a; and 69%, 43%, and 43% for pT3b (P<.001). The same figures were 97%, 90%, and 88% for Gleason sum 6 or lower; 90%, 86%, and 75% for Gleason sum 7; and 85%, 65%, and 65% for Gleason sum 8-10 (P=.01). At univariable analyses, prostate-specific antigen, pathologic Gleason score, and presence of extracapsular extension, seminal vesicle invasion, and adjuvant radiotherapy were significantly associated with BCR. At multivariable analysis, the presence of seminal vesicle invasion and the presence of Gleason sum 8-10 represented independent predictors of BCR (HR=5.14; P=.004 and HR=3.04; P=.04, respectively).
  
  
  CONCLUSIONS
  We report the longest available follow-up in RALP patients. RALP represents an oncologically effective procedure. Our oncological results support the increasing diffusion of RALP for the treatment of organ-confined PCa.
authors.affiliation: OLV Robotic Surgery Institute, Aalst, Belgium. suardi.nazareno@gmail.com
authors.forename: Nazareno
authors.initials: N
authors.lastname: Suardi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ficarra
authors.forename: Pieter
authors.initials: P
authors.lastname: Willemsen
authors.forename: Peter
authors.initials: P
authors.lastname: De Wil
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallina
authors.forename: Geert
authors.initials: G
authors.lastname: De Naeyer
authors.forename: Peter
authors.initials: P
authors.lastname: Schatteman
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.forename: Paul
authors.initials: P
authors.lastname: Carpentier
authors.forename: Alexander
authors.initials: A
authors.lastname: Mottrie
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001530:Belgium; D002423:Cause of Death; D015331:Cohort Studies; D016208:Databases, Factual; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000295:instrumentation / Q000379:methods*; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D018570:Risk Assessment; D012371:Robotics / Q000379:methods*; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D017430:Prostate-Specific Antigen