title: Robot-assisted radical prostatectomy in Hong Kong: a review of 235 cases.
abstract: OBJECTIVE
  To report the outcome of all robot-assisted laparoscopic radical prostatectomy (RALP) in the public health care system in Hong Kong.
  
  
  METHODS
  All patients who underwent RALP in the public health care system with at least 1 year of follow-up were evaluated. Data analysis included age, body mass index, preoperative prostate-specific antigen (PSA) level, D'Amico risk category, operative details, pathologic stage, follow-up continence, potency, and biochemical recurrence.
  
  
  RESULTS
  Between 2005 and 2009, 235 patients underwent RALP, with a mean age of 66.4±5.9 years and a mean preoperative PSA level of 11.0±10.5 ng/mL. Complications were 16 (7%) in total. There were 176 (74.9%) patients with pT(2) disease and 55 (23.4%) patients with pT(3) disease. The overall rate of positive surgical margins (PSM) was 20.7%. At postoperative 12 months, 72.5% of the patients were pad free. For those 83 preoperative potent patients having nerve-sparing surgery, the overall trifecta rate at 12 months was 37.3%. Multivariate analysis identified that pathologic T staging was significantly associated with PSM, with an odds ratio (OR) of 7.884 (95% confidence interval [CI]: 3.576-17.379; P<0.001) for the pT(3) group compared with the pT(2) group. When comparing D'Amico medium- and high-risk categories with low-risk categories, they were found to be significantly associated with biochemical failure (medium- compared with low-risk: OR=3.536, 95% CI: 1.253-10.173, P=0.016; high- compared with low-risk: OR=10.214, 95% CI: 2.958-35.274, P<0.001).
  
  
  CONCLUSIONS
  Our data demonstrate the feasibility, safety, and efficacy of RALP in low-to-intermediate volume centers. Our early oncologic outcomes were significantly correlated with pathologic stage and D'Amico risk stratification.
authors.affiliation: Department of Surgery, Chinese University of Hong Kong, Hong Kong.
authors.forename: Kam Hung Sidney
authors.initials: KH
authors.lastname: Yip
authors.forename: Chi-hang
authors.initials: CH
authors.lastname: Yee
authors.forename: Chi-fai
authors.initials: CF
authors.lastname: Ng
authors.forename: Nga-Yee
authors.initials: NY
authors.lastname: Lam
authors.forename: Kwan-lun
authors.initials: KL
authors.lastname: Ho
authors.forename: Wai-kit
authors.initials: WK
authors.lastname: Ma
authors.forename: Cheuk-man
authors.initials: CM
authors.lastname: Li
authors.forename: See-ming
authors.initials: SM
authors.lastname: Hou
authors.forename: Po-Chor
authors.initials: PC
authors.lastname: Tam
authors.forename: Ming-kwong
authors.initials: MK
authors.lastname: Yiu
authors.forename: Cho-wai
authors.initials: CW
authors.lastname: Fan
mesh_terms: D000368:Aged; D007172:Erectile Dysfunction / Q000209:etiology; D006723:Hong Kong; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D019990:Perioperative Care; D011467:Prostate / Q000601:surgery*; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology