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Year : 2018  |  Volume : 29  |  Issue : 1  |  Page : 43-48

Oncological outcomes of high-risk prostate cancer patients between robot-assisted laparoscopic radical prostatectomy and laparoscopic radical prostatectomy in Taiwan

Department of Urology, National University Hospital, Taipei, Taiwan

Correspondence Address:
Chao-Yuan Huang
Department of Urology, National Taiwan University Hospital, No 7, Chun-Shan South Road, Taipei
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/UROS.UROS_10_17

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Objective: To compare pathological and oncological outcomes between robotic-assisted laparoscopic radical prostatectomy (RaLRP) and laparoscopic radical prostatectomy (LRP) among high-risk prostate cancer patient in a tertiary center in Taiwan. Materials and methods: From November 2003 to October 2013, 129 high-risk prostate cancer patients receiving minimally-invasive radical prostatectomy were included. The Kaplan–Meier analysis was used for measuring biochemical recurrence-free survival (BFS). Multivariate logistic regression models and Cox proportional hazards regression models were used to determine predictors of positive surgical margin and BFS. Results: Among the 129 high-risk prostate cancer patients included, 80 (62%) patients received LRP and 49 (38%) patients received RaLRP. There was no significant difference of positive surgical margin and biochemical recurrence rate between RaLRP and LRP group (P = 0.802 and 0.292). Higher pathological T stage predicted an increased likelihood of positive margins (OR = 3.44, 95% CI [1.45, 8.18], P = 0.005). Higher initial PSA level (HR = 2.88, 95% CI [1.04, 7.94], P = 0.041) and positive surgical margin (HR = 2.55, 95% CI [1.20, 5.44], P = 0.015) were poor prognostic factors for BFS. Conclusion: RaLRP can be considered among high-risk prostate cancer in Asian people with comparable oncological outcomes to LRP. Higher pathological T stage was associated with increased likelihood of positive margins, patients with higher iPSA level and positive surgical margin had worsen biochemical recurrence-free survival.

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