Early oncological outcomes of robot‐assisted radical prostatectomy for high‐grade prostate cancer
Study Type – Therapy (case series) Level of Evidence 4 OBJECTIVE To evaluate the oncological outcomes of patients with specimen Gleason 8 and 9 prostate cancers and to determine factors that predict biochemical recurrence‐free survival (BCRFS) after robot‐assisted radical prostatectomy (RARP). PATIE...
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| Veröffentlicht in: | BJU international 2010-12, Vol.106 (11), p.1739-1745 |
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| creator | Wambi, Chris O. Siddiqui, Sameer A. Krane, L. Spencer Agarwal, Piyush K. Stricker, Hans J. Peabody, James O. |
| description | Study Type – Therapy (case series)
Level of Evidence 4
OBJECTIVE
To evaluate the oncological outcomes of patients with specimen Gleason 8 and 9 prostate cancers and to determine factors that predict biochemical recurrence‐free survival (BCRFS) after robot‐assisted radical prostatectomy (RARP).
PATIENTS AND METHODS
Of 4156 patients who underwent RARP from January 2001 to 2009, we identified 368 men with Gleason 8 or 9 tumours who met the inclusion criteria. BCR was defined as a PSA level of ≥0.2 ng/mL with a second rising value. The Kaplan–Meier method and log‐rank test were used to compare BCRFS while factors that predict BCRFS were determined by Cox proportional hazards modelling.
RESULTS
The median age and PSA level were 62 years and 6.4 ng/mL for men with Gleason 8, and 63 years and 6.7 ng/mL for Gleason 9 cancers. The median (interquartile range, IQR) overall follow‐up was 23 (10–46) months and 19 (7–37) months for Gleason 8 and 9 tumours, respectively. At 60 months the mean (se) overall BCRFS was 36 (5)% and for Gleason 8 it was 47 (6)% and for Gleason 9 it was 21 (7)% (P < 0.001). At 5 years, extraprostatic extension (pT3a) resulted in BCRFS of 52 (9)% for Gleason 8 tumours and 21 (11)% for Gleason 9 (P= 0.012). On multivariable analysis, lymph node invasion, specimen Gleason score, pathological stage and tumour volume predicted BCRFS.
CONCLUSIONS
Early results suggest RARP monotherapy performs comparably to RP for BCRFS in men with high‐grade prostate cancer. There are significant oncological differences between Gleason 8 and 9 tumours. |
| doi_str_mv | 10.1111/j.1464-410X.2010.09484.x |
| format | Article |
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Level of Evidence 4
OBJECTIVE
To evaluate the oncological outcomes of patients with specimen Gleason 8 and 9 prostate cancers and to determine factors that predict biochemical recurrence‐free survival (BCRFS) after robot‐assisted radical prostatectomy (RARP).
PATIENTS AND METHODS
Of 4156 patients who underwent RARP from January 2001 to 2009, we identified 368 men with Gleason 8 or 9 tumours who met the inclusion criteria. BCR was defined as a PSA level of ≥0.2 ng/mL with a second rising value. The Kaplan–Meier method and log‐rank test were used to compare BCRFS while factors that predict BCRFS were determined by Cox proportional hazards modelling.
RESULTS
The median age and PSA level were 62 years and 6.4 ng/mL for men with Gleason 8, and 63 years and 6.7 ng/mL for Gleason 9 cancers. The median (interquartile range, IQR) overall follow‐up was 23 (10–46) months and 19 (7–37) months for Gleason 8 and 9 tumours, respectively. At 60 months the mean (se) overall BCRFS was 36 (5)% and for Gleason 8 it was 47 (6)% and for Gleason 9 it was 21 (7)% (P < 0.001). At 5 years, extraprostatic extension (pT3a) resulted in BCRFS of 52 (9)% for Gleason 8 tumours and 21 (11)% for Gleason 9 (P= 0.012). On multivariable analysis, lymph node invasion, specimen Gleason score, pathological stage and tumour volume predicted BCRFS.
CONCLUSIONS
Early results suggest RARP monotherapy performs comparably to RP for BCRFS in men with high‐grade prostate cancer. There are significant oncological differences between Gleason 8 and 9 tumours.</description><identifier>ISSN: 1464-4096</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1111/j.1464-410X.2010.09484.x</identifier><identifier>PMID: 20575980</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Aged ; Biological and medical sciences ; cancer ; Disease-Free Survival ; Gleason ; Gynecology. Andrology. Obstetrics ; high‐grade ; Humans ; Male ; Male genital diseases ; Medical sciences ; Middle Aged ; Neoplasm Recurrence, Local - pathology ; Neoplasm Staging ; Nephrology. Urinary tract diseases ; Prospective Studies ; prostate ; Prostate - pathology ; Prostate - surgery ; Prostate-Specific Antigen - metabolism ; Prostatectomy - methods ; Prostatic Neoplasms - mortality ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - surgery ; Robotics ; Treatment Outcome ; Tumor Burden ; Tumors ; Tumors of the urinary system ; tumour volume ; Urinary tract. Prostate gland</subject><ispartof>BJU international, 2010-12, Vol.106 (11), p.1739-1745</ispartof><rights>2010 HENRY FORD HOSPITAL HEALTH SYSTEM. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL</rights><rights>2015 INIST-CNRS</rights><rights>2010 HENRY FORD HOSPITAL HEALTH SYSTEM. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3984-2885377dfe13df343d34d564cb80e7b19404ba6676e145b501613cf00fbc2c8d3</citedby><cites>FETCH-LOGICAL-c3984-2885377dfe13df343d34d564cb80e7b19404ba6676e145b501613cf00fbc2c8d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1464-410X.2010.09484.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1464-410X.2010.09484.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23464325$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20575980$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wambi, Chris O.</creatorcontrib><creatorcontrib>Siddiqui, Sameer A.</creatorcontrib><creatorcontrib>Krane, L. Spencer</creatorcontrib><creatorcontrib>Agarwal, Piyush K.</creatorcontrib><creatorcontrib>Stricker, Hans J.</creatorcontrib><creatorcontrib>Peabody, James O.</creatorcontrib><title>Early oncological outcomes of robot‐assisted radical prostatectomy for high‐grade prostate cancer</title><title>BJU international</title><addtitle>BJU Int</addtitle><description>Study Type – Therapy (case series)
Level of Evidence 4
OBJECTIVE
To evaluate the oncological outcomes of patients with specimen Gleason 8 and 9 prostate cancers and to determine factors that predict biochemical recurrence‐free survival (BCRFS) after robot‐assisted radical prostatectomy (RARP).
PATIENTS AND METHODS
Of 4156 patients who underwent RARP from January 2001 to 2009, we identified 368 men with Gleason 8 or 9 tumours who met the inclusion criteria. BCR was defined as a PSA level of ≥0.2 ng/mL with a second rising value. The Kaplan–Meier method and log‐rank test were used to compare BCRFS while factors that predict BCRFS were determined by Cox proportional hazards modelling.
RESULTS
The median age and PSA level were 62 years and 6.4 ng/mL for men with Gleason 8, and 63 years and 6.7 ng/mL for Gleason 9 cancers. The median (interquartile range, IQR) overall follow‐up was 23 (10–46) months and 19 (7–37) months for Gleason 8 and 9 tumours, respectively. At 60 months the mean (se) overall BCRFS was 36 (5)% and for Gleason 8 it was 47 (6)% and for Gleason 9 it was 21 (7)% (P < 0.001). At 5 years, extraprostatic extension (pT3a) resulted in BCRFS of 52 (9)% for Gleason 8 tumours and 21 (11)% for Gleason 9 (P= 0.012). On multivariable analysis, lymph node invasion, specimen Gleason score, pathological stage and tumour volume predicted BCRFS.
CONCLUSIONS
Early results suggest RARP monotherapy performs comparably to RP for BCRFS in men with high‐grade prostate cancer. There are significant oncological differences between Gleason 8 and 9 tumours.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>cancer</subject><subject>Disease-Free Survival</subject><subject>Gleason</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>high‐grade</subject><subject>Humans</subject><subject>Male</subject><subject>Male genital diseases</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Staging</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Prospective Studies</subject><subject>prostate</subject><subject>Prostate - pathology</subject><subject>Prostate - surgery</subject><subject>Prostate-Specific Antigen - metabolism</subject><subject>Prostatectomy - methods</subject><subject>Prostatic Neoplasms - mortality</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Robotics</subject><subject>Treatment Outcome</subject><subject>Tumor Burden</subject><subject>Tumors</subject><subject>Tumors of the urinary system</subject><subject>tumour volume</subject><subject>Urinary tract. Prostate gland</subject><issn>1464-4096</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkLtOwzAUQC0EoqXwC8gLYkqwYydxBgaoykuVWKjEZjmO3aZK6mKnotn4BL6RL8HpixUvvrr33IcOABCjEPt3Mw8xTWhAMXoPI-SzKKOMhusj0D8UjvcxypIeOHNujpBPJPEp6EUoTuOMoT5QI2GrFpqFNJWZllJU0KwaaWrloNHQmtw0P1_fwrnSNaqAVhQbaGmNa0SjZGPqFmpj4ayczjw59YQ6lKEUC6nsOTjRonLqYvcPwORh9DZ8Csavj8_Du3EgScZoEDEWkzQttMKk0ISSgtAiTqjMGVJpjjOKaC6SJE0UpnEeI5xgIjVCOpeRZAUZgOvtXL__Y6Vcw-vSSVVVYqHMyvE0y9LM-yKeZFtS-kudVZovbVkL23KMeOeYz3mnj3cqeeeYbxzztW-93C1Z5bUqDo17qR642gHCeVfaegel--OIn0ui2HO3W-6zrFT77wP4_cuki8gv73WbGQ</recordid><startdate>201012</startdate><enddate>201012</enddate><creator>Wambi, Chris O.</creator><creator>Siddiqui, Sameer A.</creator><creator>Krane, L. Spencer</creator><creator>Agarwal, Piyush K.</creator><creator>Stricker, Hans J.</creator><creator>Peabody, James O.</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201012</creationdate><title>Early oncological outcomes of robot‐assisted radical prostatectomy for high‐grade prostate cancer</title><author>Wambi, Chris O. ; Siddiqui, Sameer A. ; Krane, L. Spencer ; Agarwal, Piyush K. ; Stricker, Hans J. ; Peabody, James O.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3984-2885377dfe13df343d34d564cb80e7b19404ba6676e145b501613cf00fbc2c8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>cancer</topic><topic>Disease-Free Survival</topic><topic>Gleason</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>high‐grade</topic><topic>Humans</topic><topic>Male</topic><topic>Male genital diseases</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Staging</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Prospective Studies</topic><topic>prostate</topic><topic>Prostate - pathology</topic><topic>Prostate - surgery</topic><topic>Prostate-Specific Antigen - metabolism</topic><topic>Prostatectomy - methods</topic><topic>Prostatic Neoplasms - mortality</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - surgery</topic><topic>Robotics</topic><topic>Treatment Outcome</topic><topic>Tumor Burden</topic><topic>Tumors</topic><topic>Tumors of the urinary system</topic><topic>tumour volume</topic><topic>Urinary tract. Prostate gland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wambi, Chris O.</creatorcontrib><creatorcontrib>Siddiqui, Sameer A.</creatorcontrib><creatorcontrib>Krane, L. Spencer</creatorcontrib><creatorcontrib>Agarwal, Piyush K.</creatorcontrib><creatorcontrib>Stricker, Hans J.</creatorcontrib><creatorcontrib>Peabody, James O.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wambi, Chris O.</au><au>Siddiqui, Sameer A.</au><au>Krane, L. Spencer</au><au>Agarwal, Piyush K.</au><au>Stricker, Hans J.</au><au>Peabody, James O.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early oncological outcomes of robot‐assisted radical prostatectomy for high‐grade prostate cancer</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2010-12</date><risdate>2010</risdate><volume>106</volume><issue>11</issue><spage>1739</spage><epage>1745</epage><pages>1739-1745</pages><issn>1464-4096</issn><eissn>1464-410X</eissn><abstract>Study Type – Therapy (case series)
Level of Evidence 4
OBJECTIVE
To evaluate the oncological outcomes of patients with specimen Gleason 8 and 9 prostate cancers and to determine factors that predict biochemical recurrence‐free survival (BCRFS) after robot‐assisted radical prostatectomy (RARP).
PATIENTS AND METHODS
Of 4156 patients who underwent RARP from January 2001 to 2009, we identified 368 men with Gleason 8 or 9 tumours who met the inclusion criteria. BCR was defined as a PSA level of ≥0.2 ng/mL with a second rising value. The Kaplan–Meier method and log‐rank test were used to compare BCRFS while factors that predict BCRFS were determined by Cox proportional hazards modelling.
RESULTS
The median age and PSA level were 62 years and 6.4 ng/mL for men with Gleason 8, and 63 years and 6.7 ng/mL for Gleason 9 cancers. The median (interquartile range, IQR) overall follow‐up was 23 (10–46) months and 19 (7–37) months for Gleason 8 and 9 tumours, respectively. At 60 months the mean (se) overall BCRFS was 36 (5)% and for Gleason 8 it was 47 (6)% and for Gleason 9 it was 21 (7)% (P < 0.001). At 5 years, extraprostatic extension (pT3a) resulted in BCRFS of 52 (9)% for Gleason 8 tumours and 21 (11)% for Gleason 9 (P= 0.012). On multivariable analysis, lymph node invasion, specimen Gleason score, pathological stage and tumour volume predicted BCRFS.
CONCLUSIONS
Early results suggest RARP monotherapy performs comparably to RP for BCRFS in men with high‐grade prostate cancer. There are significant oncological differences between Gleason 8 and 9 tumours.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>20575980</pmid><doi>10.1111/j.1464-410X.2010.09484.x</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Biological and medical sciences cancer Disease-Free Survival Gleason Gynecology. Andrology. Obstetrics high‐grade Humans Male Male genital diseases Medical sciences Middle Aged Neoplasm Recurrence, Local - pathology Neoplasm Staging Nephrology. Urinary tract diseases Prospective Studies prostate Prostate - pathology Prostate - surgery Prostate-Specific Antigen - metabolism Prostatectomy - methods Prostatic Neoplasms - mortality Prostatic Neoplasms - pathology Prostatic Neoplasms - surgery Robotics Treatment Outcome Tumor Burden Tumors Tumors of the urinary system tumour volume Urinary tract. Prostate gland |
| title | Early oncological outcomes of robot‐assisted radical prostatectomy for high‐grade prostate cancer |
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