RALP Offers Favorable Long-Term Prostate Cancer Control

The 10-year rates of biochemical and clinical recurrence are comparable to those of open surgery.
The 10-year rates of biochemical and clinical recurrence are comparable to those of open surgery.

NEW ORLEANS—Robotic-assisted laparoscopic radical prostatectomy (RALP) appears to be associated with long-term cancer control comparable to open surgery, study findings presented at the American Urological Association annual meeting suggest.

Firas Abdollah, MD, of the Vattikuti Urology Institute at Henry Ford Hospital in Detroit, and colleagues analyzed outcomes of 7,105 men who underwent RALP with or without adjuvant treatment and pelvic node dissection from 2002 to 2013 at 3 tertiary care centers. The researchers defined biochemical recurrence as a PSA value of 0.2 ng/mL or higher on 2 consecutive measurements. At the time of surgery, patients had a mean age of 60.6 years and a mean PSA level of 6.6 ng/mL. Only 2.2% of patients received adjuvant treatment. The study group had a mean follow-up time of 49.4 months.

At 10 years, the overall BCR-free survival rate was 72.7%; it was 88.3%, 66.5%, and 50.4% among patients with low-, intermediate-, and higher risk disease, respectively, based on D'Amico criteria. The overall 10-year clinical recurrence (CR)-free rate was 96.5%; it was 99.9%, 97.0%, and 87.5% among patients with low-, intermediate-, and high-risk disease, respectively. On multivariable analysis, PSA, clinical stage, and biopsy Gleason score independently predicted both BCR and CR.

“These results are of great importance, given the lack of randomized trial data comparing RALP to open surgery,” the authors concluded.

RALP disseminated widely in the past decade and is now the preferred surgical approach for treating clinically localized PCa, the researchers pointed out. Most available data regarding cancer control outcomes are based on surgical margin status and pathologic stage at surgery, they noted. Long-term oncologic follow-up data for RALP have been lacking.

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