Robotic Prostate Cancer Surgery Leads to Low Recurrence Rates

A long-term study of patients who underwent robot-assisted radical prostatectomy (RARP) for prostate cancer (PC) has found that nearly 87% of them had no recurrence of the disease after five years.

Researchers at Henry Ford Hospital (Detroit, MI, USA), Case Western Reserve University (Cleveland, OH, USA), and other institutions followed 1,384 consecutive patients with localized PC who underwent RARP between September 2001 and May 2005. The patients were checked for recurrence of their cancer every three months during the first year after surgery, twice during the second year, then annually; a median of five years of follow-up was used for the study. None of the patients had secondary therapy until biochemical recurrence (BCR) was established. The researchers focused on 5-year biochemical recurrence-free survival (BCRFS).

The researchers found that in all, there were 189 incidences of BCR (31 per 1,000 person years of follow-up) at a median follow-up of 5 years. The actuarial BCRFS was 95.1% at one year, 90.6% at three years, 86.6% at five years, and 81.0% at seven years of follow-up. In the patients with recurring cancer, median time to BCR was 20.4 months; 65% of BCR incidences occurred within 3 years, and 86.2% within 5 years. On analysis, the strongest predictors of BCR were pathologic Gleason grade 8-10 and pathologic stage T3b/T4. The study was published in the November 2010 issue of the European Urology Journal.

"With five-year actuarial biochemical recurrence-free survival outcomes of 86.6%, robot-assisted radical prostatectomy appears to confer effective five-year prostate cancer control,” concluded lead author Mani Menon, M.D., and colleagues.

RARP is a treatment in which the entire diseased prostate gland and some surrounding tissue are surgically removed, in hope of preventing the cancer from spreading to other parts of the body. Early studies found that about 35% of men suffered a recurrence within 10 years after undergoing traditional radical prostatectomy. The researchers suspected, however, that those results might have become outdated as the use of prostate-specific antigen (PSA) screening gained wider acceptance, allowing prostate cancer to be detected in more men at a younger age.

Related Links:
Henry Ford Hospital
Case Western Reserve University