Prostate cancer biochemical recurrence rates after robot-assisted laparoscopic radical prostatectomy
Serge Ginzburg, MD1, Ilene Staff, PhD2, Joseph Tortora, BA2, Alison Champagne, BS2, Steven J. Shichman, MD2, Stuart S. Kesler, MD2, Vincent P. Laudone, MD3, Joseph R. Wagner, MD2.
1University of Connecticut, Farmington, CT, USA, 2Hartford Hospital, Hartford, CT, USA, 3Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
BACKGROUND: To determine prostate cancer cumulative biochemical recurrence-free survival for patients undergoing robot assisted laparoscopic radical prostatectomy (RALP)
METHODS: A retrospective review of a prospectively maintained, Internal Review Board (IRB) approved radical prostatectomy database was performed. Using preoperative data, patients were stratified as low, intermediate, and high risk according to D’Amico’s risk classification. Pathologic specimens were categorized by Gleason score, TNM stage (2002 AJCC Cancer Staging), and margin status. Postoperative PSA values were routinely obtained at 1, 3, 6, 9, 12, 18, 24, 36, 48, and 60 months. Biochemical recurrence (PSA recurrence) was defined as >0.2 ng/dl. Patients receiving salvage treatment were considered as having recurred. Kaplan-Meier curves for cumulative biochemical recurrence-free survival were generated with SPSS v 14.
RESULTS: 1464 patients underwent RALP between January 1, 2004 and December 31, 2008 at our institution. Figure 1 demonstrates cumulative biochemical recurrence-free survival according to Gleason score and pathologic stage, for positive and negative surgical margins. Figure 2 demonstrates cumulative biochemical recurrence-free survival according to D’Amico’s risk classification and for the overall cohort, for positive and negative surgical margins. Cumulative biochemical recurrence-free survival for the overall cohort at 60 months after surgery was 58% and 80% for those with positive and negative surgical margins, respectively.
CONCLUSIONS: Our biochemical recurrence rates for RALP compare favorably with open series. Documenting biochemical recurrence rates for RALP in a multi-institutional fashion is important as this treatment for localized prostate cancer is validated.