Biochemical recurrence of pathological T2+localized prostate cancer after robotic-assisted radical prostatectomy:A 10-year surveillance

作     者：Che Hseuh Yang Yi Sheng Lin Yen Chuan Ou Wei Chun Weng Li Hua Huang Chin Heng Lu Chao Yu Hsu Min Che Tung 

作者机构：Division of UrologyDepartment of SurgeryTungs'Taichung MetroHarbor HospitalTaichung 435403Taiwan 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2021年第9卷第5期

页      面：1026-1036页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Prostatectomy/methods Robotic surgical procedures Prostatic neoplasms/pathology Prostate-specific antigen/metabolism Margins of excision Retrospective study 

摘      要：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 *** 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 *** study had the longest follow-up on pT2+PCa after robotic-assisted RP since ***,we discussed our viewpoints on pT2+PCa based on real-world *** To conclude a 10-year surveillance on pT2+PCa and compare our results with those of the published *** Forty-eight patients who underwent robotic-assisted RP between 2008 and 2011 were *** serial tests of prostate specific antigen(PSA)≥0.2 ng/mL were defined as *** designed factors were analyzed using statistical tools for BCR *** 9.4 was applied and significance was defined as P***,multivariate,linear regression,and receiver operating characteristic(ROC)curve analyses were performed for statistical *** 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 *** PSA was significantly different between the BCR and non-BCR groups(P0.001),and ROC curve analysis of preoperative PSA suggested a cutoff 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 *** PSA cut-off value of 19.09 ng/mL is a predictive factor for *** on our experiences and review of the literat