Ten-Year Oncologic Outcomes of Prostate Cancer after Robotic-Assisted Laparoscopic Radical Prostatectomy: Single Center Experience
Yodkhunnatham N, MD1, Taweemonkongsap T, MD1, Ramart P, MD1, Jitpraphai S, MD1, Hansomwong T, MD1, Leewansangtong S, MD1, Srinualnad S, MD1, Nualyong C, MD1, Woranisarakul V, MD1
Affiliation : 1 Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To evaluate oncologic outcomes after robotic-assisted laparoscopic radical prostatectomy (RALRP) compared with
and without neurovascular bundle (NVB) sparing, and to study associating factors that affect biochemical recurrence (BCR) and
survival outcome.
Materials and Methods : All charts of prostate cancer patients who underwent RALRP during 2007 and 2017 were reviewed. Collected
data included demographic information, initial prostate-specific antigen (PSA), operative technique, pathology report, perioperative
data, complications, BCR rate, time to recurrence, and overall survival rate. All variables were compared among the non-NVB
sparing, unilateral NVB sparing, and bilateral NVB sparing groups.
Results : A total of 1,048 patients were included in this study. Pathological staging was pT1 in 2.3%, pT2 in 57.1%, and pT3 in 40.6%
of patients. The median follow-up time was 5 years. The BCR rates were 17.3%, 20.0%, and 21.4% in the non-NVB sparing, unilateral
NVB sparing, and bilateral NVB sparing groups, respectively (p = 0.339). Unilateral or bilateral NVB sparing had no effect on mean
time to BCR (8.83 vs. 8.89 years; p = 0.544). There was no significant difference in 10-year overall survival among the non-sparing,
unilateral sparing, and bilateral sparing groups (98.6%, 98.7%, and 99.4%, respectively; p = 0.562). Multivariate analysis confirmed
that NVB sparing did not affect the BCR rate (hazard ratio: 1.108, 95% confidence interval: 0.827 to 1.942; p = 0.549).
Conclusion : The results of the present study revealed that NVB sparing in RALRP had no significant impact on BCR rate or survival
outcome compared to the non-NVB sparing group.
Keywords : Prostate cancer, Robotic-assisted laparoscopic radical prostatectomy, Oncologic outcomes, Biochemical recurrence, Neurovascular bundle sparing
