Stratified analysis of 800 Asian patients after robot-assisted radical prostatectomy with a median 64 months of follow up
Stratified analysis of 800 Asian patients after robot-assisted radical prostatectomy with a median 64 months of follow up
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DOI：
10.1111/iju.13151
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发表时间：
2016-09-01
影响因子：
2.6
通讯作者：
Rha, Koon Ho
中科院分区：
文献类型：
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作者：
Raheem, Ali Abdel;Kim, Dae Keun;Rha, Koon Ho
ObjectiveTo 5年的肿瘤学结果的机器人辅助根治性直肠癌切除术从最大的系列有史以来报道从亚洲.MethodsA回顾性分析了800例亚洲患者谁是治疗与机器人辅助根治性直肠癌切除术从2005年7月至2010年5月在泌尿外科和泌尿科学研究所，延世大学医学院，首尔，韩国进行了。主要终点是评估生化复发。次要终点是显示生化无复发生存，无转移生存和癌症特异性survival.ResultsA共197（24.65%），218（27.3%），和385（48.1%）例患者被归类为低，中，高风险患者根据D 'Amico风险分层风险标准，分别。中位随访期为64个月（四分位距28-71个月）。手术切缘阳性率为36.6%。183例（22.9%）生化复发，38例（4.8%）发生远处转移，24例（3%）死于前列腺癌。5年的精算生化无复发生存率、无转移生存率和癌症特异性生存率分别为76.4%、94.6%和96.7%。淋巴结阳性者5年生化无复发生存率（9.1%）、肿瘤特异性生存率（75.7%）和无转移生存率（61.9%）较低（P < 0.001）。在多变量分析中，在所有的预测因子中，淋巴结阳性是生化复发、癌症特异性生存和无转移生存的最强预测因子（P < 0.001）。机器人辅助根治性直肠癌切除术被证实是一种肿瘤学安全的手术，即使在高危疾病患者中也能够提供有效的5年癌症控制。
ObjectiveTo report the 5-year oncological outcomes of robot-assisted radical prostatectomy from the largest series ever reported from Asia.MethodsA retrospective analysis of 800 Asian patients who were treated with robot-assisted radical prostatectomy from July 2005 to May 2010 in the Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea was carried out. The primary end-point was to evaluate the biochemical recurrence. The secondary end-point was to show the biochemical recurrence-free survival, metastasis-free survival and cancer-specific survival.ResultsA total of 197 (24.65%), 218 (27.3%), and 385 (48.1%) patients were classified as low-, intermediate- and high-risk patients according to the D'Amico risk stratification risk criteria, respectively. The median follow-up period was 64 months (interquartile range 28-71 months). The overall incidence of positive surgical margin was 36.6%. There was biochemical recurrence in 183 patients (22.9%), 38 patients (4.8%) developed distant metastasis and 24 patients (3%) died from prostate cancer. Actuarial biochemical recurrence-free survival, metastasis-free survival, and cancer-specific survival rates at 5 years were 76.4%, 94.6% and 96.7%, respectively. Positive lymph node was associated with lower 5-year biochemical recurrence-free survival (9.1%), cancer-specific survival (75.7%) and metastasis-free survival (61.9%) rates (P < 0.001). On multivariable analysis, among all the predictors, positive lymph node was the strongest predictor of biochemical recurrence, cancer-specific survival and metastasis-free survival (P < 0.001).ConclusionsHerein we report the largest robot-assisted radical prostatectomy series from Asia. Robot-assisted radical prostatectomy is confirmed to be an oncologically safe procedure that is able to provide effective 5-year cancer control, even in patients with high-risk disease.