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Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
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Preoperative Predictive Factors for Seminal Vesicle Invasion (pT3b) in Robotic-assisted Radical Prostatectomy
Kazuhiko Oshinomi1, Shota Kikuchi1, Hirotaka Kishi1
1Department of Urology, Showa University School of Medicine, Tokyo, Japan.
Cancer Diagnosis & Prognosis
|May 5, 2025
Summary
The International Society of Urological Pathology (ISUP) grade group at biopsy is the key preoperative predictor for pT3b seminal vesicle invasion in robot-assisted radical prostatectomy (RARP). This finding helps anticipate recurrence risk after surgery.
Area of Science:
- Urology
- Oncology
- Surgical Innovation
Background:
- Robot-assisted radical prostatectomy (RARP) outcomes are linked to surgeon experience.
- Accurate preoperative staging is vital to prevent unexpected pT3b upgrades (seminal vesicle invasion).
Purpose of the Study:
- To identify preoperative predictive factors for pT3b seminal vesicle invasion in patients undergoing RARP.
Main Methods:
- Analysis of 246 RARP cases (2013-2020) without neoadjuvant hormone therapy.
- Preoperative staging utilized magnetic resonance imaging (MRI) and 12-site prostate biopsies.
- Statistical analysis included Cox proportional hazards, logistic regression, and Kaplan-Meier methods.
Main Results:
- The 3-year prostate-specific antigen (PSA) recurrence-free survival was 87%, but significantly lower (70%) in pT3b cases.
- Multivariate logistic regression identified the ISUP grade group at biopsy as the sole significant preoperative predictor for pT3b.
Conclusions:
- pT3b stage is associated with a higher risk of postoperative biochemical recurrence.
- ISUP grade group at biopsy is a crucial preoperative factor for predicting pT3b in RARP patients.
