title: Oncological outcomes following robotic-assisted radical prostatectomy in a multiracial Asian population.
abstract: This study evaluates the oncological outcomes of RARP in a multiracial Asian population from a single institution. All suitable patients from 1st January 2003-30th June 2013 were identified from a prospectively maintained cancer registry. Peri-operative and oncological outcomes were analysed. Significance was defined as p < 0.05. There were n = 725 patients identified with a mean follow-up duration 28 months. The mean operative time, EBL and LOS were 186 min, 215 ml and 3 days, respectively. The pathological stage was pT2 in 68.6% (n = 497/725), pT3 in 31.3% (n = 227/725) and n = 1 patient with pT4 disease. The pathological Gleason scores (GS) were 6 in 27.9% (n = 202/725), GS 7 in 63.6% (n = 461/725) and GS ≥ 8 in 8.0 % (n = 58/725). The node positivity rate was 5.8% (n = 21/360). The positive margin rates were 31.0% (n = 154/497) and 70.9% (n = 161/227) for pT2 and pT3, respectively, and decreasing PSM rates are observed with surgical maturity. The biochemical recurrence rates were 9.7% (n = 48/497) and 34.2% (n = 78/228) for pT2 and pT3/T4, respectively. On multivariate analysis, independent predictors of BCR were pathological T stage and pathological Gleason score. Post-operatively, 78.5% (n = 569/725) of patients had no complications and 17.7% (n = 128/725) had minor (Clavien grade I-II) complications. This series, representing the largest from Southeast Asia, suggests that RARP can be a safe and oncologically feasible treatment for localised prostate cancer in an institution with moderate workload.
authors.affiliation: Department of Urology, Singapore General Hospital, Level 5, The Academia, 20 College Road, Singapore, 169856, Singapore. alvinlwx@gmail.com.
authors.forename: Low Wei Xiang
authors.identifier: http://orcid.org/0000-0003-4844-9678
authors.initials: LW
authors.lastname: Alvin
authors.affiliation: Department of Urology, Singapore General Hospital, Level 5, The Academia, 20 College Road, Singapore, 169856, Singapore.
authors.forename: Sim Hong
authors.initials: SH
authors.lastname: Gee
authors.affiliation: Department of Urology, Singapore General Hospital, Level 5, The Academia, 20 College Road, Singapore, 169856, Singapore.
authors.forename: Huang Hong
authors.initials: HH
authors.lastname: Hong
authors.affiliation: Department of Urology, Singapore General Hospital, Level 5, The Academia, 20 College Road, Singapore, 169856, Singapore.
authors.forename: Cheng Wai Sam
authors.initials: CW
authors.lastname: Christopher
authors.affiliation: Department of Urology, Singapore General Hospital, Level 5, The Academia, 20 College Road, Singapore, 169856, Singapore.
authors.forename: Ho Sien Sun
authors.initials: HS
authors.lastname: Henry
authors.affiliation: Department of Urology, Singapore General Hospital, Level 5, The Academia, 20 College Road, Singapore, 169856, Singapore.
authors.forename: Lau Kam On
authors.initials: LK
authors.lastname: Weber
authors.affiliation: Department of Pathology, Singapore General Hospital, Singapore, 169856, Singapore.
authors.forename: Tan Puay
authors.initials: TP
authors.lastname: Hoon
authors.affiliation: Department of Urology, Singapore General Hospital, Level 5, The Academia, 20 College Road, Singapore, 169856, Singapore. lee.lui.shiong@sgh.com.sg.
authors.forename: Lee Lui
authors.initials: LL
authors.lastname: Shiong
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D002681:China; D006801:Humans; D007194:India; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome
keywords: Asian population; Localised disease; Oncological outcomes; Prostate cancer; Robotic prostatectomy