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Biochemical recurrence after chemohormonal therapy followed by robot-assisted radical prostatectomy in very-high-risk prostate cancer patients

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Abstract

Robot-assisted radical prostatectomy (RARP) has become one of the standard radical treatments for prostate cancer (PCa). A retrospective single-center cohort study was conducted on patients with PCa who underwent RARP at Gifu University Hospital between September 2017 and September 2022. In this study, patients were classified into three groups based on the National Comprehensive Cancer Network risk classification: low/intermediate-risk, high-risk, and very-high-risk groups. Patients with high- and very-high-risk PCa who were registered in the study received neoadjuvant chemohormonal therapy prior to RARP. Biochemical recurrence-free survival (BRFS) after RARP in patients with PCa was the primary endpoint of this study. The secondary endpoint was the relationship between biochemical recurrence (BCR) and clinical covariates. We enrolled 230 patients with PCa in our study, with a median follow-up of 17.0 months. When the time of follow-up was over, 19 patients (8.3%) had BCR, and the 2 years BRFS rate for the enrolled patients was 90.9%. Although there was no significant difference in BRFS between the low- and intermediate-risk group and the high/very-high-risk group, the 2 years BRFS rate was 100% in the high-risk group and 68.3% in the very-high-risk group (P = 0.0029). Multivariate analysis showed that positive surgical margins were a significant predictor of BCR in patients with PCa treated with RARP. Multimodal therapies may be necessary to improve the BCR in patients with very-high-risk PCa.

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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Urology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan

    Fumiya Sugino, Keita Nakane, Makoto Kawase, Toyohiro Yamada, Sanae Namiki, Naotaka Kumada, Kota Kawase, Daiki Kato, Manabu Takai, Koji Iinuma, Yuki Tobisawa & Takuya Koie

  2. Department of Urology, Japanese Red Cross Takayama Hospital, Takayama, Japan

    Shota Ueda

  3. Department of Urology, Chuno Kosei Hospital, Seki, Japan

    Masayuki Tomioka

  4. Department of Urology, Japanese Red Cross Gifu Hospital, Gifu, Japan

    Yasumichi Takeuchi

  5. Center for Clinical Training and Career Development, Gifu University Graduate School of Medicine, Gifu, Japan

    Takayasu Ito

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  1. Fumiya Sugino
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Contributions

FS: Data analysis, manuscript writing/editing; data collection and management; MK: Data collection and management; SU: Data collection and management; MT: Data collection and management; YT: Data collection and management; TY: Data collection and management; SN: Data collection and management; NK: Data collection and management; KK: Data collection and management; DK: Data collection and management; MT: Data collection and management; KI: Protocol/project development and supervision; KN: Protocol/project development and supervision; YT: Data collection and management; TI: Data collection and management; TK: Protocol/project development, data management, manuscript writing/editing.

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Correspondence to Takuya Koie.

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Sugino, F., Nakane, K., Kawase, M. et al. Biochemical recurrence after chemohormonal therapy followed by robot-assisted radical prostatectomy in very-high-risk prostate cancer patients. J Robotic Surg 17, 2441–2449 (2023). https://doi.org/10.1007/s11701-023-01670-3

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