title: Risk factors for biochemical recurrence after robotic assisted radical prostatectomy: a single surgeon experience.
abstract: BACKGROUND
  Radical prostatectomy is a standard surgical treatment of clinically localized prostate cancer. Margin status has been found to be an independent predictor of biochemical recurrence (BCR) after open radical prostatectomy in several large series but this is still controversy in Robotic Assisted Radical Prostatectomy (RARP) series. We therefore wanted to investigate the prognostic significance of positive surgical margin (PSM) and other pathological factors on BCR in patients treated with RARP by a single surgeon.
  
  
  METHODS
  Prospectively collected data of 439 patients treated with RARP between October 2005 and June 2013 by a single surgeon at a single institution were analyzed. BCR was defined as follow-up PSA level > 0.2 ng/ml on two separate occasions or patients who had to undergo salvage therapy. Kaplan Meier curves and Log Rank test were used to compare the risk of BCR. Univariate and Multivariate Cox Regression analyses were performed to determine the prognostic impact of age, BMI, prostate weight, PSA prior to surgery, pathological T-stage, pathological Gleason sum, PSM and operative period.
  
  
  RESULTS
  In this study period, 34 out of 439 had BCR, giving an overall BCR rate of 7.7% for this cohort. Overall 2- and 3-year BCR-free survival rates were 93% and 88%, respectively. Patients with a PSM had a 2-year BCR free survival of 88% compared to 94% in those with negative margins (p < .0001). On the multivariate analysis, PSM as well as pathological Gleason sum > = 8, PSA, pathological stage and operative period were significantly associated with BCR.
  
  
  CONCLUSIONS
  In our case series of RARP performed by a single surgeon, PSM as well as pathological Gleason sum, PSA, pathological stage and early operative period for this surgeon were the independent predictors of BCR.
authors: Department of Urology, Kimmel Cancer Center, Thomas Jefferson University, 1025 Walnut St. Suite 1112, Philadelphia, PA, 19107, USA. tanimo10@gmail.com.
authors: Ryuta
authors: R
authors: Tanimoto
authors: Department of Urology, Kimmel Cancer Center, Thomas Jefferson University, 1025 Walnut St. Suite 1112, Philadelphia, PA, 19107, USA. yomine05@gmail.com.
authors: Yomi
authors: Y
authors: Fashola
authors: Department of Urology, Kimmel Cancer Center, Thomas Jefferson University, 1025 Walnut St. Suite 1112, Philadelphia, PA, 19107, USA. scotland.kb@gmail.com.
authors: Kymora B
authors: KB
authors: Scotland
authors: Department of Urology, Kimmel Cancer Center, Thomas Jefferson University, 1025 Walnut St. Suite 1112, Philadelphia, PA, 19107, USA. Anne.Calvaresi@jefferson.edu.
authors: Anne E
authors: AE
authors: Calvaresi
authors: Department of Urology, Kimmel Cancer Center, Thomas Jefferson University, 1025 Walnut St. Suite 1112, Philadelphia, PA, 19107, USA. Leonard.Gomella@jefferson.edu.
authors: Leonard G
authors: LG
authors: Gomella
authors: Department of Urology, Kimmel Cancer Center, Thomas Jefferson University, 1025 Walnut St. Suite 1112, Philadelphia, PA, 19107, USA. Edouard.Trabulsi@jefferson.edu.
authors: Edouard J
authors: EJ
authors: Trabulsi
authors: Department of Urology, Kimmel Cancer Center, Thomas Jefferson University, 1025 Walnut St. Suite 1112, Philadelphia, PA, 19107, USA. Costas.Lallas@jefferson.edu.
authors: Costas D
authors: CD
authors: Lallas
mesh_terms: D000368:Aged; D015992:Body Mass Index; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D012307:Risk Factors; D012371:Robotics
chemical_list: D017430:Prostate-Specific Antigen