Contemporaneous comparison of open vs minimally-invasive radical prostatectomy for high-risk prostate cancer
Identifieur interne : 002463 ( Ncbi/Checkpoint ); précédent : 002462; suivant : 002464Contemporaneous comparison of open vs minimally-invasive radical prostatectomy for high-risk prostate cancer
Auteurs : Phillip M. Pierorazio ; Jeffrey K. Mullins ; John B. Eifler ; Kipp Voth ; Elias S. Hyams ; Misop Han ; Christian P. Pavlovich ; Trinity J. Bivalacqua ; Alan W. Partin ; Mohamad E. Allaf ; Edward M. SchaefferSource :
- BJU international [ 1464-4096 ] ; 2013.
Abstract
• To analyze pathological and short-term oncological outcomes in men undergoing open and minimally-invasive radical prostatectomy (MIRP) for high-risk prostate cancer (HRPC; prostate-specific antigen level [PSA] >20 ng/mL, ≥cT2c, Gleason score 8–10) in a contemporaneous series.
• In total, 913 patients with HRPC were identified in the Johns Hopkins Radical Prostatectomy Database subsequent to the inception of MIRP at this institution (2002–2011)
• Of these, 743 (81.4%) underwent open radical retropubic prostatectomy (ORRP), 105 (11.5%) underwent robot-assisted laparoscopic radical prostatectomy (RALRP) and 65 (7.1%) underwent laparoscopic radical prostatectomy (LRP) for HRPC.
• Appropriate comparative tests were used to evaluate patient and prostate cancer characteristics.
• Proportional hazards regression models were used to predict biochemical recurrence.
• Age, race, body mass index, preoperative PSA level, clinical stage, number of positive cores and Gleason score at final pathology were similar between ORRP and MIRP.
• On average, men undergoing MIRP had smaller prostates and more organ-confined (pT2) disease (
• The number of surgeons and surgeon experience were greatest for the ORRP cohort.
• Overall surgical margin rate was 29.4%, 34.3% and 27.7% (
• Biochemical recurrence-free survival among ORRP, RALRP and LRP was 56.3%, 67.8% and 41.1%, respectively, at 3 years (
• At an experienced centre, MIRP is comparable to open radical prostatectomy for HRPC with respect to surgical margin status and biochemical recurrence.
Url:
DOI: 10.1111/j.1464-410X.2012.11757.x
PubMed: 23356390
PubMed Central: 3978171
Affiliations:
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Hyams</name></author><author><name sortKey="Han, Misop" sort="Han, Misop" uniqKey="Han M" first="Misop" last="Han">Misop Han</name></author><author><name sortKey="Pavlovich, Christian P" sort="Pavlovich, Christian P" uniqKey="Pavlovich C" first="Christian P." last="Pavlovich">Christian P. Pavlovich</name></author><author><name sortKey="Bivalacqua, Trinity J" sort="Bivalacqua, Trinity J" uniqKey="Bivalacqua T" first="Trinity J." last="Bivalacqua">Trinity J. Bivalacqua</name></author><author><name sortKey="Partin, Alan W" sort="Partin, Alan W" uniqKey="Partin A" first="Alan W." last="Partin">Alan W. Partin</name></author><author><name sortKey="Allaf, Mohamad E" sort="Allaf, Mohamad E" uniqKey="Allaf M" first="Mohamad E." last="Allaf">Mohamad E. Allaf</name></author><author><name sortKey="Schaeffer, Edward M" sort="Schaeffer, Edward M" uniqKey="Schaeffer E" first="Edward M." last="Schaeffer">Edward M. Schaeffer</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23356390</idno><idno type="pmc">3978171</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3978171</idno><idno type="RBID">PMC:3978171</idno><idno type="doi">10.1111/j.1464-410X.2012.11757.x</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">001690</idno><idno type="wicri:Area/Pmc/Curation">001690</idno><idno type="wicri:Area/Pmc/Checkpoint">001348</idno><idno type="wicri:Area/Ncbi/Merge">002463</idno><idno type="wicri:Area/Ncbi/Curation">002463</idno><idno type="wicri:Area/Ncbi/Checkpoint">002463</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Contemporaneous comparison of open vs minimally-invasive radical prostatectomy for high-risk prostate cancer</title><author><name sortKey="Pierorazio, Phillip M" sort="Pierorazio, Phillip M" uniqKey="Pierorazio P" first="Phillip M." last="Pierorazio">Phillip M. Pierorazio</name></author><author><name sortKey="Mullins, Jeffrey K" sort="Mullins, Jeffrey K" uniqKey="Mullins J" first="Jeffrey K." last="Mullins">Jeffrey K. Mullins</name></author><author><name sortKey="Eifler, John B" sort="Eifler, John B" uniqKey="Eifler J" first="John B." last="Eifler">John B. Eifler</name></author><author><name sortKey="Voth, Kipp" sort="Voth, Kipp" uniqKey="Voth K" first="Kipp" last="Voth">Kipp Voth</name></author><author><name sortKey="Hyams, Elias S" sort="Hyams, Elias S" uniqKey="Hyams E" first="Elias S." last="Hyams">Elias S. Hyams</name></author><author><name sortKey="Han, Misop" sort="Han, Misop" uniqKey="Han M" first="Misop" last="Han">Misop Han</name></author><author><name sortKey="Pavlovich, Christian P" sort="Pavlovich, Christian P" uniqKey="Pavlovich C" first="Christian P." last="Pavlovich">Christian P. Pavlovich</name></author><author><name sortKey="Bivalacqua, Trinity J" sort="Bivalacqua, Trinity J" uniqKey="Bivalacqua T" first="Trinity J." last="Bivalacqua">Trinity J. Bivalacqua</name></author><author><name sortKey="Partin, Alan W" sort="Partin, Alan W" uniqKey="Partin A" first="Alan W." last="Partin">Alan W. Partin</name></author><author><name sortKey="Allaf, Mohamad E" sort="Allaf, Mohamad E" uniqKey="Allaf M" first="Mohamad E." last="Allaf">Mohamad E. Allaf</name></author><author><name sortKey="Schaeffer, Edward M" sort="Schaeffer, Edward M" uniqKey="Schaeffer E" first="Edward M." last="Schaeffer">Edward M. Schaeffer</name></author></analytic><series><title level="j">BJU international</title><idno type="ISSN">1464-4096</idno><idno type="eISSN">1464-410X</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title><p id="P1">• To analyze pathological and short-term oncological outcomes in men undergoing open and minimally-invasive radical prostatectomy (MIRP) for high-risk prostate cancer (HRPC; prostate-specific antigen level [PSA] >20 ng/mL, ≥cT2c, Gleason score 8–10) in a contemporaneous series.</p></sec><sec id="S2"><title>Patients and Methods</title><p id="P2">• In total, 913 patients with HRPC were identified in the Johns Hopkins Radical Prostatectomy Database subsequent to the inception of MIRP at this institution (2002–2011)</p><p id="P3">• Of these, 743 (81.4%) underwent open radical retropubic prostatectomy (ORRP), 105 (11.5%) underwent robot-assisted laparoscopic radical prostatectomy (RALRP) and 65 (7.1%) underwent laparoscopic radical prostatectomy (LRP) for HRPC.</p><p id="P4">• Appropriate comparative tests were used to evaluate patient and prostate cancer characteristics.</p><p id="P5">• Proportional hazards regression models were used to predict biochemical recurrence.</p></sec><sec id="S3"><title>Results</title><p id="P6">• Age, race, body mass index, preoperative PSA level, clinical stage, number of positive cores and Gleason score at final pathology were similar between ORRP and MIRP.</p><p id="P7">• On average, men undergoing MIRP had smaller prostates and more organ-confined (pT2) disease (<italic>P</italic> = 0.02).</p><p id="P8">• The number of surgeons and surgeon experience were greatest for the ORRP cohort.</p><p id="P9">• Overall surgical margin rate was 29.4%, 34.3% and 27.7% (<italic>P</italic> = 0.52) and 1.9%, 2.9% and 6.2% (<italic>P</italic> = 0.39) for pT2 disease in men undergoing ORRP, RALRP and LRP, respectively.</p><p id="P10">• Biochemical recurrence-free survival among ORRP, RALRP and LRP was 56.3%, 67.8% and 41.1%, respectively, at 3 years (<italic>P</italic> = 0.6) and the approach employed did not predict biochemical recurrence in regression models.</p></sec><sec id="S4"><title>Conclusions</title><p id="P11">• At an experienced centre, MIRP is comparable to open radical prostatectomy for HRPC with respect to surgical margin status and biochemical recurrence.</p></sec></div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Allaf, Mohamad E" sort="Allaf, Mohamad E" uniqKey="Allaf M" first="Mohamad E." last="Allaf">Mohamad E. Allaf</name><name sortKey="Bivalacqua, Trinity J" sort="Bivalacqua, Trinity J" uniqKey="Bivalacqua T" first="Trinity J." last="Bivalacqua">Trinity J. Bivalacqua</name><name sortKey="Eifler, John B" sort="Eifler, John B" uniqKey="Eifler J" first="John B." last="Eifler">John B. Eifler</name><name sortKey="Han, Misop" sort="Han, Misop" uniqKey="Han M" first="Misop" last="Han">Misop Han</name><name sortKey="Hyams, Elias S" sort="Hyams, Elias S" uniqKey="Hyams E" first="Elias S." last="Hyams">Elias S. Hyams</name><name sortKey="Mullins, Jeffrey K" sort="Mullins, Jeffrey K" uniqKey="Mullins J" first="Jeffrey K." last="Mullins">Jeffrey K. Mullins</name><name sortKey="Partin, Alan W" sort="Partin, Alan W" uniqKey="Partin A" first="Alan W." last="Partin">Alan W. Partin</name><name sortKey="Pavlovich, Christian P" sort="Pavlovich, Christian P" uniqKey="Pavlovich C" first="Christian P." last="Pavlovich">Christian P. Pavlovich</name><name sortKey="Pierorazio, Phillip M" sort="Pierorazio, Phillip M" uniqKey="Pierorazio P" first="Phillip M." last="Pierorazio">Phillip M. Pierorazio</name><name sortKey="Schaeffer, Edward M" sort="Schaeffer, Edward M" uniqKey="Schaeffer E" first="Edward M." last="Schaeffer">Edward M. Schaeffer</name><name sortKey="Voth, Kipp" sort="Voth, Kipp" uniqKey="Voth K" first="Kipp" last="Voth">Kipp Voth</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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