A contemporary analysis of disease upstaging of Gleason 3 + 3 prostate cancer patients after robot-assisted laparoscopic prostatectomy.
Cancer Med
; 12(22): 20830-20837, 2023 11.
Article
in En
| MEDLINE
| ID: mdl-37929881
ABSTRACT
BACKGROUND:
Risk of biochemical recurrence (BCR) in localised prostate cancer can be stratified using the 5-tier Cambridge Prognostic Group (CPG) or 3-tier European Association of Urology (EAU) model. Active surveillance is the current recommendation if CPG1 or EAU low-risk criteria are met. We aimed to determine the contemporary rates of upgrading, upstaging and BCR after radical prostatectomy for CPG1 or EAU low-risk disease.METHODS:
A database of all robotic-assisted laparoscopic prostatectomies (RALPs) performed in Glasgow between 12/2015 and 05/2022 was analysed. Rates of upgrading, upstaging and BCR post-RALP for CPG1 or EAU low-risk disease were defined. Univariate and multivariate analysis were performed to assess the relationship between patient factors and outcomes.RESULTS:
A total of 1223 RALP cases were identified. A total of 12.6% met CPG1 criteria with 70.1% and 25.3% upgraded and upstaged to extraprostatic disease post-operatively respectively. A total of 5.8% met EAU low-risk criteria with 60.6% upgraded and 25.4% upstaged to extraprostatic disease post-operatively respectively. CPG1 (p < 0.0001) and EAU low-risk (p = 0.02) patients were at a significantly higher risk of BCR if upstaged.DISCUSSION:
Many patients who met CPG1 or EAU low-risk criteria were upgraded post-RALP and approximately 25% were upstaged due to extraprostatic disease. Upstaging puts patients at a significantly higher risk of BCR.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prostatic Neoplasms
/
Robotics
/
Laparoscopy
Limits:
Humans
/
Male
Language:
En
Journal:
Cancer Med
Year:
2023
Document type:
Article
Affiliation country:
Reino Unido