BACKGROUND: High-risk prostate cancer treatment has been controversial. Some high-risk prostate cancer patients fail to respond to radical prostatectomy only. Thus, we aimed to investigate the predictive factors for biochemical recurrence (BCR) and identify patients who could achieve sufficient therapeutic effect by radical prostatectomy only. METHODS: Of 264 medical records reviewed, 141 low-intermediate-risk and 100 high-risk prostate cancer patients, excluding those who had received neoadjuvant hormone therapy, were analyzed. BCR was defined as the first increase in prostate-specific antigen levels (≥ 0.2 ng/mL), with levels not decreasing to undetectable limits, after radical prostatectomy. Log-rank test and Cox proportional hazards regression analyses were performed to determine the prognostic factors. We investigated the perioperative predictive factors for BCR and BCR-free survival rates, with the number of National Comprehensive Cancer Network (NCCN) high-risk factors for high-risk prostate cancer patients who underwent robot-assisted radical prostatectomy. RESULTS: Multivariate analyses showed that clinical T3 was significantly associated with BCR [hazard ratio (HR) = 4.052; 95% confidence interval (CI), 1.26-12.99; P = 0.019]. Of the 100 patients, 77 had 1 high-risk factor and 23 had ≥ 2 high-risk factors; the 1-year BCR-free survival rate of patients with 1 high-risk factor and those with ≥ 2 high-risk factors was 94.8% and 69.6%, respectively. Patients with ≥ 2 high-risk factors were significantly associated with BCR (P = 0.002). No difference in BCR rate between patients with 1 high-risk factor and those with low- and intermediate-risk was found. CONCLUSION: High-risk prostate cancer patients with 1 NCCN high-risk factor can be considered for robot-assisted radical prostatectomy treatment only.
BACKGROUND: High-risk prostate cancer treatment has been controversial. Some high-risk prostate cancerpatients fail to respond to radical prostatectomy only. Thus, we aimed to investigate the predictive factors for biochemical recurrence (BCR) and identify patients who could achieve sufficient therapeutic effect by radical prostatectomy only. METHODS: Of 264 medical records reviewed, 141 low-intermediate-risk and 100 high-risk prostate cancerpatients, excluding those who had received neoadjuvant hormone therapy, were analyzed. BCR was defined as the first increase in prostate-specific antigen levels (≥ 0.2 ng/mL), with levels not decreasing to undetectable limits, after radical prostatectomy. Log-rank test and Cox proportional hazards regression analyses were performed to determine the prognostic factors. We investigated the perioperative predictive factors for BCR and BCR-free survival rates, with the number of National Comprehensive Cancer Network (NCCN) high-risk factors for high-risk prostate cancerpatients who underwent robot-assisted radical prostatectomy. RESULTS: Multivariate analyses showed that clinical T3 was significantly associated with BCR [hazard ratio (HR) = 4.052; 95% confidence interval (CI), 1.26-12.99; P = 0.019]. Of the 100 patients, 77 had 1 high-risk factor and 23 had ≥ 2 high-risk factors; the 1-year BCR-free survival rate of patients with 1 high-risk factor and those with ≥ 2 high-risk factors was 94.8% and 69.6%, respectively. Patients with ≥ 2 high-risk factors were significantly associated with BCR (P = 0.002). No difference in BCR rate between patients with 1 high-risk factor and those with low- and intermediate-risk was found. CONCLUSION: High-risk prostate cancerpatients with 1 NCCN high-risk factor can be considered for robot-assisted radical prostatectomy treatment only.
Authors: Pedro Recabal; Melissa Assel; John E Musser; Ronald J Caras; Daniel D Sjoberg; Jonathan A Coleman; John P Mulhall; Raul O Parra; Peter T Scardino; Karim Touijer; James A Eastham; Vincent P Laudone Journal: J Urol Date: 2016-02-22 Impact factor: 7.450
Authors: Steven Joniau; Alberto Briganti; Paolo Gontero; Giorgio Gandaglia; Lorenzo Tosco; Steffen Fieuws; Bertrand Tombal; Giansilvio Marchioro; Jochen Walz; Burkhard Kneitz; Pia Bader; Detlef Frohneberg; Alessandro Tizzani; Markus Graefen; Paul van Cangh; R Jeffrey Karnes; Francesco Montorsi; Hein Van Poppel; Martin Spahn Journal: Eur Urol Date: 2014-01-25 Impact factor: 20.096
Authors: Andrew J Stephenson; Peter T Scardino; Fernando J Bianco; Christopher J DiBlasio; Paul A Fearn; James A Eastham Journal: J Urol Date: 2004-12 Impact factor: 7.450
Authors: Giovanni Battista Di Pierro; Pietro Grande; Johann Gregory Wirth; Hansjörg Danuser; Agostino Mattei Journal: Can Urol Assoc J Date: 2015 Mar-Apr Impact factor: 1.862
Authors: Axel Heidenreich; Patrick J Bastian; Joaquim Bellmunt; Michel Bolla; Steven Joniau; Theodor van der Kwast; Malcolm Mason; Vsevolod Matveev; Thomas Wiegel; Filiberto Zattoni; Nicolas Mottet Journal: Eur Urol Date: 2013-11-12 Impact factor: 20.096
Authors: Michel Bolla; Laurence Collette; Léo Blank; Padraig Warde; Jean Bernard Dubois; René-Olivier Mirimanoff; Guy Storme; Jacques Bernier; Abraham Kuten; Cora Sternberg; Johan Mattelaer; José Lopez Torecilla; J Rafael Pfeffer; Carmel Lino Cutajar; Alfredo Zurlo; Marianne Pierart Journal: Lancet Date: 2002-07-13 Impact factor: 79.321
Authors: Gerald E Hanks; Thomas F Pajak; Arthur Porter; David Grignon; Harmart Brereton; Varagur Venkatesan; Eric M Horwitz; Colleen Lawton; Seth A Rosenthal; Howard M Sandler; William U Shipley Journal: J Clin Oncol Date: 2003-11-01 Impact factor: 44.544