Long-term Cancer Control Outcomes After Robot-assisted Radical Prostatectomy in Pathologically Non-organ-confined...

Area of Science:

• Urology
• Oncology
• Robotic Surgery

Background:

• Long-term efficacy data for robot-assisted laparoscopic prostatectomy (RALP) in non-organ-confined, high-risk prostate cancer (PC) remains limited.
• This study addresses the need for evidence on RALP's long-term oncological outcomes in this challenging patient subset.

Purpose of the Study:

• To evaluate the long-term oncological outcomes of patients with non-organ-confined, high-risk PC treated with RALP.
• To provide insights for patient counseling regarding long-term results after RALP for aggressive PC.

Main Methods:

• Retrospective analysis of 803 patients with pathologically non-organ-confined, high-risk PC undergoing RALP between 2001 and 2022.
• Kaplan-Meier and competing-risks methods were used to estimate survival rates (OS, PCSS) and treatment-free survival.
• Cox regression identified predictors of PC-specific mortality, any-cause mortality, and need for additional treatment.

Main Results:

• The 20-year prostate cancer-specific survival (PCSS) rate was 72.7%, and overall survival (OS) was 45.2%.
• Rates of survival free from additional treatment were 31.3% at 10 years and 20.3% at 15 years.
• Pathological stage pT3b-4 was an independent predictor for increased PC-specific mortality, any-cause mortality, and need for additional treatment.

Conclusions:

• RALP achieves durable long-term oncological control in patients with non-organ-confined, high-risk PC.
• This study offers the longest follow-up data for RALP as primary treatment in aggressive PC, aiding in patient counseling.