Robot-Assisted Surgery for Localized Prostate Cancer Controls Disease for 10 Years
Robot-assisted surgery to remove cancerous prostate glands is effective in controlling the disease for 10 years, according to a new study led by researchers at Henry Ford Hospital. The study by Diaz et al, published in European Urology, also suggested that traditional methods of measuring the severity and possible spread of the cancer together with molecular techniques have the potential to help create personalized, cost-effective treatment regimens for prostate cancer patients who undergo the surgical procedure.
The findings apply to men whose cancer has not spread beyond the prostate, and the results are comparable to the well-established and more invasive open surgery to remove the entire diseased prostate and some surrounding tissue.
“Until our analysis, there was little available information on the long-term oncologic outcomes for patients who undergo robot-assisted radical prostatectomy,” said Mireya Diaz, PhD, Director of Biostatistics at the Henry Ford’s Vattikuti Urology Institute and lead author of the study.
Study Details
The researchers followed 483 consecutive men with localized prostate cancer who underwent robotic-assisted radical prostatectomy as first-line therapy from 2001 to 2003. Using several standard measures of cancer-treatment success—including biochemical markers of recurrence, incidence of metastasis, and cancer-specific survival—the researchers found that 98.8% of the patients survived cancer for 10 years after their surgery.
Further analysis showed that the severity of the cancer after robotic-assisted radical prostatectomy was the best predictor of a recurrence, and the level of prostate-specific antigen (PSA) in the bloodstream can be combined with severity to determine future treatment.
Personalized Treatment Regimens
“Disease severity and postoperative PSA measurements can guide physicians in identifying the varying levels of cancer recurrence risk,” Dr. Diaz explained. “This includes those patients who can best benefit from secondary treatment as well as long-term monitoring.”
The study suggests that persistent PSA levels after robotic-assisted radical prostatectomy signals the risk that cancer may progress and soon require a second or salvage treatment of another kind. Lower-risk patients after robotic-assisted radical prostatectomy warrant careful monitoring within 5 years after surgery and more protracted later, while those at higher risk may need follow-up monitoring beyond 10 years.
Further research and the collection of consistent, solid evidence will allow the creation of more personalized regimens for cost-effective treatment following robotic-assisted radical prostatectomy, the study concluded.
Dr. Diaz is the corresponding author for the European Urology article.
The study was funded Vattikuti Urology Institute.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
