The Impact of Gleason Grade 3 as a Predictive Factor for Biochemical Recurrence after Robot-Assisted Radical Prostatectomy: A Retrospective Multicenter Cohort Study in Japan (The MSUG94 Group)
Makoto Kawase,
Shin Ebara,
Tomoyuki Tatenuma,
Takeshi Sasaki,
Yoshinori Ikehata,
Akinori Nakayama,
Masahiro Toide,
Tatsuaki Yoneda,
Kazushige Sakaguchi,
Jun Teishima,
Kazuhide Makiyama,
Takahiro Inoue,
Hiroshi Kitamura,
Kazutaka Saito,
Fumitaka Koga,
Shinji Urakami,
Takuya Koie
Affiliations
Makoto Kawase
Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan
Shin Ebara
Department of Urology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima 7308518, Japan
Tomoyuki Tatenuma
Department of Urology, Yokohama City University, Yokohama 2360004, Japan
Takeshi Sasaki
Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu 5148507, Japan
Yoshinori Ikehata
Department of Urology, University of Toyama, Toyama 9300194, Japan
Akinori Nakayama
Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya 3438555, Japan
Masahiro Toide
Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 1138677, Japan
Tatsuaki Yoneda
Department of Urology, Seirei Hamamatsu General Hospital, Hamamatsu 4308558, Japan
Kazushige Sakaguchi
Department of Urology, Toranomon Hospital, Tokyo 1058470, Japan
Jun Teishima
Department of Urology, Kobe City Hospital Organization Kobe City Medical Center West Hospital, Kobe 6530013, Japan
Kazuhide Makiyama
Department of Urology, Yokohama City University, Yokohama 2360004, Japan
Takahiro Inoue
Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu 5148507, Japan
Hiroshi Kitamura
Department of Urology, University of Toyama, Toyama 9300194, Japan
Kazutaka Saito
Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya 3438555, Japan
Fumitaka Koga
Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 1138677, Japan
Shinji Urakami
Department of Urology, Toranomon Hospital, Tokyo 1058470, Japan
Takuya Koie
Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan
Background and Objectives: This study’s objective was to examine patients treated with robot-assisted radical prostatectomy (RARP) for intermediate-risk prostate cancer (IR-PCa), and to identify preoperative risk factors for biochemical recurrence (BCR) in these patients in Japan. Materials and Methods: We conducted a retrospective multicenter cohort study of patients with PCa who underwent RARP at 10 institutions in Japan. A total of 3195 patients were enrolled in this study. We focused on patients with IR-PCa who underwent RARP. We obtained data on pre- and postoperative covariates from the enrolled patients. Biochemical recurrence-free survival was the primary endpoint of this study. We also identified useful preoperative predictive factors for BCR in patients with IR-PCa after RARP. Results: A total of 1144 patients with IR-PCa were enrolled in this study. The median follow-up period was 23.7 months. At the end of the follow-up period, 94 (8.2%) patients developed BCR. The 2 and 3 year biochemical recurrence-free survival (BRFS) rates were 92.2% and 90.2%, respectively. Using the Kaplan–Meier method, Gleason grade (GG) 3 was significantly associated with poor BRFS compared with ≤GG 2. In multivariate analysis, GG 3 was a significant predictive factor for BCR in patients with IR-PCa. Conclusions: The results of the study indicated a significant relationship between GG 3 and post-RARP BCR in patients with IR-PCa.
