title: Robot-assisted radical prostatectomy in low- and high-risk prostate cancer patients.
abstract: OBJECTIVE
  To evaluate the benefit of robot-assisted radical prostatectomy (RARP) in the low-risk prostate cancer (PCa) patients suitable for active surveillance and in the high-risk PCa patients who would be considered for alternative treatments such as radiotherapy (RT) and androgen deprivation therapy (ADT) instead of radical prostatectomy.
  
  
  METHODS
  Of 548 patients, who underwent RARP, 298 PCa patients (258 low-risk and 40 high-risk) with a mean of 3.6 years follow-up, were included into this study. Oncological outcomes were compared separately in low- and high-risk PCa patients.
  
  
  RESULTS
  The pathologic Gleason scores were ≥7 in 73 (28%), and 68 (26%) patients had a pathologic stage of T3, 29 (11%) patients had a positive surgical margin (PSM), and 20 (7%) patients had biochemical recurrence (BCR) in the first year follow-up in the low-risk group. Of 258 low-risk PCa patients, a total of 93 (36%) patients had not either BCR, pathologic Gleason score ≥7, or ≥pT3 disease with PSM. In the high-risk group, the pathologic stage was pT2 in 14 (35%) patients and 29 (72%) patients had no biochemical recurrence in the follow-up of these high-risk PCa patients. Of 40 high-risk PCa patients, in a total of 25 (62.5%) patients ≥pT3b disease, BCR, pT3a disease with PSM were not detected.
  
  
  CONCLUSIONS
  Approximately two thirds of high-risk PCa patients benefit from RARP without additional RT or ADT. Besides, more than one third of low-risk PCa patients who fit active surveillance criteria would have unfavorable results.
authors.affiliation: Clinic of Urology, Health Sciences University, Ümraniye Training and Research Hospital, İstanbul, Turkey.
authors.forename: Uğur
authors.initials: U
authors.lastname: Boylu
authors.affiliation: Clinic of Urology, Health Sciences University, Ümraniye Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Bindayi
authors.affiliation: Clinic of Urology, Health Sciences University, Ümraniye Training and Research Hospital, İstanbul, Turkey.
authors.forename: Eyüp Veli
authors.initials: EV
authors.lastname: Küçük
authors.affiliation: Clinic of Urology, Health Sciences University, Ümraniye Training and Research Hospital, İstanbul, Turkey.
authors.forename: Fikret Fatih
authors.initials: FF
authors.lastname: Önol
authors.affiliation: Clinic of Urology, Health Sciences University, Ümraniye Training and Research Hospital, İstanbul, Turkey.
authors.forename: Eyüp
authors.initials: E
authors.lastname: Gümüş
keywords: High-risk; low-risk; prostate cancer; prostatectomy