title: Oncologic outcomes at 10 years following robotic radical prostatectomy.
abstract: BACKGROUND
  Reports on long-term oncologic outcomes for patients who undergo robot-assisted radical prostatectomy (RARP) are scant, as for radical prostatectomy covering only the contemporary prostate-specific antigen (PSA) era.
  
  
  OBJECTIVE
  To evaluate cancer control in men who underwent RARP at least 10 yr ago.
  
  
  METHODS
  From 2001 to 2003, we followed 483 consecutive men with localized prostate cancer who underwent RARP at a high-volume tertiary center.
  
  
  METHODS
  RARP as first-line therapy.
  
  
  METHODS
  We calculated biochemical recurrence -free survival (BCRFS), metastasis-free survival (MFS), and cancer-specific survival (CSS). Actuarial rates were estimated via Kaplan-Meier. Cox proportional hazards models were used to identify variables predictive of biochemical recurrence (BCR), receipt of salvage therapy, and metastases.
  
  
  CONCLUSIONS
  There were 108 patients with BCR at a median follow-up of 121 mo (interquartile range: 97-132). Actuarial BCRFS, MFS, and CSS rates at 10 yr were 73.1%, 97.5%, and 98.8%, respectively. On multivariable analysis, D'Amico risk groups or pathologic Gleason grade, stage, and margins were the strongest predictors of BCR depending on whether preoperative or postoperative variables were considered. The value of the detectable PSAs together with disease severity were independent predictors of receipt of salvage therapy, together with a persistent PSA for metastases.
  
  
  CONCLUSIONS
  In contemporary patients with localized prostate cancer, RARP confers effective 10-yr cancer control. Disease severity and PSA measurements can be used to guide more personalized and cost-effective postoperative surveillance regimens.
  
  
  RESULTS
  Robot-assisted radical prostatectomy confers effective 10-yr cancer control for men with localized disease, similar to the open approach. Recurrence is best predicted by postoperative disease severity. Persistent disease signals the risk of progression likely requiring early salvage treatment; lower postoperative risk warrants protracted surveillance beyond 5 yr from surgery, and those with higher risk may require follow-up beyond 10 yr.
authors.affiliation: Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA; Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA. Electronic address: mdiazmail-web@yahoo.com.
authors.forename: Mireya
authors.initials: M
authors.lastname: Diaz
authors.affiliation: Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: James O
authors.initials: JO
authors.lastname: Peabody
authors.affiliation: Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Victor
authors.initials: V
authors.lastname: Kapoor
authors.affiliation: Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Jesse
authors.initials: J
authors.lastname: Sammon
authors.affiliation: Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Craig G
authors.initials: CG
authors.lastname: Rogers
authors.affiliation: Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Hans
authors.initials: H
authors.lastname: Stricker
authors.affiliation: Department of Pathology, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Zhaoli
authors.initials: Z
authors.lastname: Lane
authors.affiliation: Department of Pathology, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Nilesh
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Mahendra
authors.initials: M
authors.lastname: Bhandari
authors.affiliation: Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA; Case Western Reserve University, Cleveland, OH, USA; New York University, New York, NY, USA; University of Toledo School of Medicine, Toledo, OH, USA.
authors.forename: Mani
authors.initials: M
authors.lastname: Menon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading / Q000706:statistics & numerical data; D009362:Neoplasm Metastasis / Q000517:prevention & control; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control; D009367:Neoplasm Staging / Q000706:statistics & numerical data; D011467:Prostate / Q000473:pathology / Q000601:surgery*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000379:methods*; D016879:Salvage Therapy / Q000379:methods; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen
keywords: Cancer control; Postoperative surveillance; Prostate cancer; Prostatectomy; Robotics