Risk stratification and early oncologic outcomes following robotic prostatectomy

Ardavan Akhavan, Adam W. Levinson, Paul Muntner, Fatima Nabizada-Pace, David B. Samadi

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Objectives: Although the popularity of robotic-assisted laparoscopic prostatectomy is assured, little is known about the oncologic outcomes following the procedure. Methods: We performed a retrospective cohort study including consecutive patients who underwent the surgery between 2003 and 2007 with at least 6 months of follow-up (n 464). Patients were stratified into low-, in-termediate-, and high-risk groups according to D'Amico criteria. Biochemical failure was defined as a PSA 0.2 ng/mL. Results: Of study patients, 256 (55%), 171 (37%), and 37 (8%) were classified as low-, intermediate-, and high-risk, respectively. Over a mean follow-up of 14.1 months (range, 6.0 to 55.3), 7.3% experienced biochemical failure. Biochemical disease-free survival at 30 months was 94%, 79%, and 73% among patients in the low-, intermediate-, and high-risk groups, respectively, (P 0.001). Preoperative risk stratification was strongly associated with biochemical failure, with hazard ratios of 5.04 (95%: 1.52 to 16.7; P 0.001) and 7.04 (95%: 1.39 to 35.6; P 0.001) for intermediate- and high-over low-risk groups, respectively. The ability of risk stratification to predict biochemical failure had an area under the receiver operator characteristic curve of 0.74. Conclusion: Robotic prostatectomy provides excellent cancer control outcomes for clinically localized disease.

Original languageEnglish (US)
Pages (from-to)515-521
Number of pages7
JournalJournal of the Society of Laparoendoscopic Surgeons
Volume13
Issue number4
DOIs
StatePublished - Oct 2009

Keywords

  • Outcome assessment
  • Prostatectomy
  • Prostatic neoplasms
  • Robotics

ASJC Scopus subject areas

  • Surgery

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