TY - JOUR
T1 - Risk stratification and early oncologic outcomes following robotic prostatectomy
AU - Akhavan, Ardavan
AU - Levinson, Adam W.
AU - Muntner, Paul
AU - Nabizada-Pace, Fatima
AU - Samadi, David B.
N1 - Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.
PY - 2009/10
Y1 - 2009/10
N2 - 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.
AB - 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.
KW - Outcome assessment
KW - Prostatectomy
KW - Prostatic neoplasms
KW - Robotics
UR - http://www.scopus.com/inward/record.url?scp=77949564098&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77949564098&partnerID=8YFLogxK
U2 - 10.4293/108680809X12589998404164
DO - 10.4293/108680809X12589998404164
M3 - Article
C2 - 20202392
AN - SCOPUS:77949564098
VL - 13
SP - 515
EP - 521
JO - Journal of the Society of Laparoendoscopic Surgeons
JF - Journal of the Society of Laparoendoscopic Surgeons
SN - 1086-8089
IS - 4
ER -