INTRODUCTION AND OBJECTIVE:
Robotic radical prostatectomy (RARP) is a standalone therapeutic modality, with the need for salvage radiotherapy often treated as an unpredictable setback. In fact it’s an added therapeutic factor. We analysed prospectively collected clinical, radiological and pathological data from a single surgeon series of RARPs.
Data from patients undergoing RARP between 2015 and 2020, with a minimum of 12 months’ follow up were analysed. Descriptive statistical analysis was conducted, and relative risk was calculated for selected variables of interest.
802 cases were reviewed; 800 were included for analysis, minimum follow-up of 35 months, median follow-up 15.1months. Median age 62.5; median PSA at presentation 7.0. Overall, 17.1% (n = 134) required salvage radiotherapy. On surgical histopathology, positive margins were associated with a relative risk increase of 2.45 (95% CI 1.81, 3.33; p<0.01) and lymphovascular invasion with a relative risk increase of 3.50 (95% CI 2.62, 4.67; p<0.01).
This comprehensive dataset represents part of one of the largest series for radical prostatectomy in the UK. Analysis of these data have allowed us to precisely advise our patients on the likelihood that they will need salvage radiotherapy after radical prostatectomy, enabling optimally informed conversations both before and after surgery. Also to set expectations and optimism for cure. As functions of disease, not surgery, it is reasonable to expect these results to be generalisable.
Source of Funding: