Robot-assisted radical prostatectomy (RARP) is comparable to conventional RP with regard to biochemical recurrence-free survival (BCRFS) in men with high-grade prostate cancer (PCa), study findings suggest. Results also revealed significant oncologic differences between Gleason 8 and 9 tumors.
Investigators led by Chris O. Wambi, MD, of the Vattikuti Urology Institute at Henry Ford Hospital in Detroit studied 368 men with Gleason 8 or 9 tumors and met study entry criteria. The researchers defined biochemical recurrence as a PSA level of 0.2 ng/mL or higher with a second rising volume.
The median age of the patients with Gleason 8 and 9 tumors was 62 and 63 years, respectively. The median PSA level prior to surgery was 6.4 and 6.7 ng/mL, respectively. The median follow-up was 23 and 19 months for those with Gleason 8 and 9 tumors, respectively. At 60 months, the mean overall BCRFS was 36%. Men with Gleason 8 tumors had significantly better BCRFS than those with Gleason 9 tumors (47% vs. 21%), investigators reported in BJU International (2010;106:1739-1745). In addition, extraprostatic extension (pT3a) resulted in BCRFS of 52% for Gleason 8 tumors and 21% for Gleason 9, a significant difference.