Robot-assisted radical prostatectomy: 5-year oncological and biochemical outcomes.
OBJECTIVE
We investigated oncological outcomes in patients who underwent robot-assisted radical prostatectomy more than 5 years previously.


METHODS
Between June 2002 and August 2006 we prospectively followed 435 consecutive patients who underwent robot-assisted radical prostatectomy. Five patients were excluded from analysis, including 4 lost to followup and 1 with prior therapy. Biochemical recurrence was denoted as 1) adjuvant therapy or 2) 2 prostate specific antigen values above 0.2 ng/ml. Biochemical recurrence-free survival, and patient and tumor characteristics were investigated.


RESULTS
Mean ± SD patient age was 61.4 ± 7.1 years. A total of 289 patients (63%) had 5 or more years of followup and 4 (1%) were lost to followup. Median time to biochemical recurrence was 18 months (range 1 month to 9.1 years). Four patients (0.93%) died of prostate cancer. The 5-year biochemical recurrence-free survival rate was 84.9% (95% CI 81.4-88.4). Five-year biochemical recurrence-free survival was 94.4% (95% CI 91.7-97.1) for pT2 disease compared to 63.8% (95% CI 53.4-74.1) and 47.1% (95% CI 27.3-67.0) for pT3a and pT3b, respectively (p <0.001). Patients with a Gleason score of 3 or less + 3, 3 + 4, 4 + 3 and 4 or greater + 4 experienced a 5-year biochemical recurrence-free survival of 97%, 86%, 62% and 43%, respectively (p <0.001). Patients with positive margins had a 5-year biochemical recurrence-free survival of 60.7% (95% CI 48.7-72.7) compared to 89.6% (95% CI 86.3-92.9) in those with negative margins (p <0.001).


CONCLUSIONS
This represents the third report of the oncological outcomes of robot-assisted radical prostatectomy, demonstrating a 5-year biochemical recurrence rate of approximately 14% and just below 1% prostate cancer specific mortality.
Department of Urology, University of California-Irvine, Orange, California 92602, USA.
Michael A
MA
Liss
Achim
A
Lusch
Blanca
B
Morales
Nima
N
Beheshti
Douglas
D
Skarecky
Navneet
N
Narula
Kathryn
K
Osann
Thomas E
TE
Ahlering
D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D012371:Robotics; D013997:Time Factors; D016896:Treatment Outcome
D017430:Prostate-Specific Antigen