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Updated: Jun 13, 2026

Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
[Carcinologic outcomes after radical prostatectomy in 81 high-risk patients]
A Carcenac1, F Arroua, J Gaudart
1Service d'urologie, CHU du Nord-de-Marseille, chemin des Bourrely, Marseille, France. Aurelien.Carcenac@ap-hm.fr
Objectives:
To evaluate carcinologic outcomes and biologic recurrence (BR) factor after radical prostatectomy (RP) for high-risk (HR) prostate cancer.
Material And Methods:
Between 1996 and 2006, 81 consecutives RP (65 with standard lymphadenectomy) have been done by a single surgeon for HR cancer according to d'Amico classification. No patient received neo-adjuvant therapy. Minimum follow-up required was 2 years. The BR was defined by two consecutives PSA greater than 0.2 ng/ml. Forty patients required immediate adjuvant therapy. Thirty for patients required secondary therapy. A multivariate analysis have been done for the following factors: age at RP, TNM stage, pre- and postoperative PSA, Gleason score, number of positive core biopsy, number of HR factor, positive surgical margin and immediate adjuvant therapy.
Results:
Mean age was 64 years. Median follow-up was 71 month. Forty-nine patients was pT3 (60.5 %), seven was pN+(8.7 %) and 40 had positive surgical margin (49.4 %). The 5 years biological recurrence free survival rate was 42 %. The Gleason score (p=0.003, RR=1.688, IC=1.193-2.387), the preoperative PSA (p=0.001, RR=1.06, IC=1.032-1.089) and the number of positive core biopsy (p=0.006, RR=5.316, IC=1.605-17.607) were significant independent prognostic factors for the BR. The number of HR factor, positive surgical margin and immediate adjuvant therapy were not significant independent prognostic factors for the BR.
Conclusions:
At 5 years, RP in HR prostate cancer allowed carcinologic control without BR in 34 patients (42 %). This result was not influenced by the number of HR factor, surgical positive margin and immediate adjuvant therapy.
