Long term biochemical recurrence free survival after radical prostatectomy for cancer: Comparative analysis according to surgical approach and clinicopathological stage

Objective. - To assess long term biochemical recurrence free survival after radical prostatectomy according to open, laparoscopic and robot-assisted surgical approach and clinicopathological stage. Material and methods.- A cohort study of 1313 consecutive patients treated by radical prostatectomy for localized or locally advanced prostate cancer between 2000 and 2013. Open surgery (63.7%), laparoscopy (10%) and robot-assisted laparoscopy (26.4%) were performed. Biochemical recurrence was defined by PSA > 0,1 ng/mL. The biochemical recurrence free survival was described by Kaplan Meier method and prognostic factors were analysed by multivariable Cox regression. Results. - Median follow-up was 57 months (IQR: 31-90). Ten years biochemical recurrence free survival was 88.5%, 71.6% and 53.5% respectively for low, intermediate and high-risk D'Amico groups. On multivariable analysis, the worse prognostic factor was Gleason score (P < 0.001). Positive surgical margins rate was 53% in pT3 tumours and 24% in pT2 tumours (P < 0.001). Biochemical recurrence free survival (P = 0.06) and positive surgical margins rate (P = 0.87) were not statistically different between the three surgical approaches. Conclusion. - Biochemical recurrence free survival in our study does not differ according to surgical approach and is similar to published series. Ten years biochemical recurrence free survival for high-risk tumours without hormone therapy is 54% justifying the role of surgery in the therapeutic conversations in this group of tumours. (C) 2014 Elsevier Masson SAS. All rights reserved.