Influence of pathological factors on oncological outcomes after robot-assisted radical prostatectomy for XXXX : Results of a prospective study.

@entity1 @entity263 @entity5 @entity3 @entity5436
PURPOSE: To assess the prognostic significance of @entity3 ( @entity3 ), maximum @entity5 diameter (MTD), high-grade @entity5436 , perineural invasion, and length of positive surgical margins after robot-assisted radical prostatectomy (RARP). METHODS: A single-institution prospective analysis of all @entity1 who underwent RARP for @entity263 was performed between January 2005 and June 2013. The primary end point was biochemical recurrence-free survival (BRFS). BRFS was estimated using the Kaplan-Meier method and compared to that from the log-rank test. Cox* s proportional hazards regression univariate and multivariate analyses were performed to define the prognostic factors. RESULTS: Overall, 742 @entity1 were included. After a median follow-up of 31.4 months, biochemical recurrence occurred in 80 @entity1 (10.8%). BRFS was 93%, 87%, and 80.7% at 1, 3, and 5 years, respectively. Progression to local recurrence occurred in 49 @entity1 (6.6%). During the follow-up period, 3 @entity1 experienced progression to @entity3 and were treated with hormonotherapy. No @entity1 died of disease during the study period. In multivariate analyses, Gleason score was the strongest predictor of BRFS (hazard ratio [HR] = 3.4; P<0.001). There were 3 other predictive factors of BRFS were @entity3 (HR = 7.64; P = 0.005), MTD (HR = 4.04; P =0.009), and margin length>= 3mm (HR = 1.25; P = 0.04). CONCLUSION: In the era of serum prostate-specific antigen testing maturity in conjunction with a single approach to extirpation of the prostate gland by RARP, @entity3 , MTD, and positive surgical margins>= 3mm are prognostic factors associated with BRFS after RARP. Consideration could be given to incorporate them in the pathology report of the radical prostatectomy specimens and they could assist physicians in clinical decision making.
