Dados do Trabalho

Título

PREDICTORS OF ADVERSE PATHOLOGICAL FEATURES FOLLOWING ROBOTIC RADICAL PROSTATECTOMY IN PATIENTS WITH LOW-RISK PROSTATE CANCER.

Resumo

Introduction
This paper aims to determine the proportion of low-risk prostate cancer patients who exhibit adverse pathological features(APF) after undergoing robotic radical prostatectomy(RARP).

Methods
We reviewed all consecutive patients undergoing an RARP for low-risk prostate cancer, based on the D'Amico Risk Classification. APF was defined as extracapsular extension, seminal vascular invasion, positive surgical margins, ISUP grade group ≥ 3, or lymph node metastasis.

Results
In total, 4,042 patients were included. The median values for age were 60 years old, BMI=27.7kg/m2, PSA=4.8ng/mL, prostate weight=51gm, and PSA density=0.09ng/mL2.
1,043 patients(26%) had APF features compared to 2,999 patients with no APF(74%). On multivariable analysis, only older age (62 vs 60 years old, OR=1.05, p-value<0.001), higher BMI (27.9 vs 27.5kg/m2, OR=1.04, p-value<0.001), background of smoking (31.2% vs 24.4%, OR=1.22, p-value=0.018), lower prostate weight (48 vs 52 grams, OR=0.98, p-value=0.002), presence of a MRI-lesion ≥ PI-RADS 3 (14.5% vs 8.4%, OR=1.80, p-value<0.001) remained significant between groups.
Patients with APF had higher rates of biochemical persistence(1.9% vs. 0.07%, p-value<0.001) and 10-year cumulative incidence rates of BCR(19.8% vs. 3.2%, cumulative incidence rates difference=16.6%, 95%CI=12.5-20.6%) compared to patients with no APF.

Conclusions
In our study, over a quarter of patients with low-risk prostate cancer undergoing RARP exhibited APF. We identified that older age, higher BMI, history of smoking, lower prostate weight, and presence of MRI-lesion≥ PI-RADS 3 were associated with APF. Patients with APF experienced elevated rates of biochemical persistence and BCR compared to those without APF.