Biochemical recurrence of pathological T2+ localized prostate cancer after robotic-assisted radical prostatectomy: A 10-year surveillance
| Autor: | Yen Chuan Ou, Chao-Yu Hsu, Wei Chun Weng, Yi Sheng Lin, Min Che Tung, Che Hseuh Yang, Li Hua Huang, Chin Heng Lu |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Biochemical recurrence
medicine.medical_specialty Robotic assisted medicine.medical_treatment Urology urologic and male genital diseases 03 medical and health sciences Prostate cancer Margins of excision 0302 clinical medicine Retrospective Study hemic and lymphatic diseases medicine Robotic surgical procedures Pathological Prostate-specific antigen/metabolism Prostatic neopl-asms/pathology Prostatectomy business.industry technology industry and agriculture food and beverages Robotic Surgical Procedures Retrospective cohort study General Medicine medicine.disease carbohydrates (lipids) body regions Prostatectomy/methods 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology business human activities |
| Zdroj: | World Journal of Clinical Cases |
| ISSN: | 2307-8960 |
| DOI: | 10.12998/wjcc.v9.i5.1026 |
| Popis: | BACKGROUND pT2+ prostate cancer (PCa), a term first used in 2004, refers to organ-confined PCa characterized by a positive surgical margin (PSM) without extracapsular extension. Patients with a PSM are vulnerable to biochemical recurrence (BCR) following radical prostatectomy (RP); however, whether adjuvant radiotherapy (aRT) is imperative to PSM after RP remains controversial. This study had the longest follow-up on pT2+ PCa after robotic-assisted RP since 2004. Moreover, we discussed our viewpoints on pT2+ PCa based on real-world experiences. AIM To conclude a 10-year surveillance on pT2+ PCa and compare our results with those of the published literature. METHODS Forty-eight patients who underwent robotic-assisted RP between 2008 and 2011 were enrolled. Two serial tests of prostate specific antigen (PSA) ≥ 0.2 ng/mL were defined as BCR. Various designed factors were analyzed using statistical tools for BCR risk. SAS 9.4 was applied and significance was defined as P < 0.05. Univariate, multivariate, linear regression, and receiver operating characteristic (ROC) curve analyses were performed for statistical analyses. RESULTS With a median follow-up period of 9 years, 25 (52%) patients had BCR (BCR group), and the remaining 23 (48%) patients did not (non-BCR group). The median time for BCR test was 4 years from the first postoperative PSA nadir. Preoperative PSA was significantly different between the BCR and non-BCR groups (P < 0.001), and ROC curve analysis of preoperative PSA suggested a cut-off value of 19.09 ng/mL (sensitivity, 0.600; specificity: 0.739). The linear regression analysis showed no correlation between time to BCR and preoperative PSA (Pearson’s correlation, 0.13; adjusted R2 = 0.026). CONCLUSION Robotic-assisted RP in pT2+ PCa of worse conditions can provide better BCR-free survival. A surgical technique limiting the PSM in favorable situations is warranted to lower the pT2+ PCa BCR rate. Preoperative PSA cut-off value of 19.09 ng/mL is a predictive factor for BCR. Based on our experiences and review of the literature, we do not recommend routine aRT for pT2+ PCa. |
| Databáze: | OpenAIRE |
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