Laparoscopic/ Robotic: Prostate

Moderated Poster Session

MP15-21 - Contemporary trends in prostate cancer characteristics at robotic-assisted radical prostatectomy (RALP) in a high-volume referral center

Saturday, September 22
10:00 AM - 12:00 PM
Location: Room 242B

Introduction & Objective :

Various factors including the increasing use of active surveillance for low-risk prostate cancer, the US Preventive Services Task Force (USPSTF)’s recommendation against PSA-based screening, and changes in referral patterns have influenced oncological parameters in patients receiving robotic-assisted laparoscopic radical prostatectomy (RALP) in recent years. We analyzed contemporary practice patterns in men that underwent RALP in our high volume center.


Methods : We retrospectively analyzed our IRB approved prostate cancer database. All consecutive patients who underwent RALP between 2009 and 2015 (n=5,095) were evaluated. USPSFT’s recommendation in 2012 was selected as a reference point to compare changes in operative and pathological characteristics, which created 2 groups (Group I: 2009 to 2012 and Group II: 2013 to 2015, Table 1). We analyzed the differences in clinical, surgical and pathological characteristics between the groups.


Results : Mean pre-operative PSA increased from 6.05 ng/mL to 7.28 ng/mL (p . The proportion of D'Amico intermediate and high risk patients increased by 16.1% (50.3% vs 66.2%, p<0.001). There was a 14% increase in non-organ confined disease (Table 1). In parallel, there was a significant decrease in complete nerve sparing (NS) (from 59.3% to 35.7%) and increase in partial NS rate (from 24% to 64.3%) (Figure 1). We found a significant rise in adverse pathological features including Gleason score, extra-prostatic extension, seminal vesicle invasion and node positivity (Table 1). 


Conclusions :

There is a shift towards increased high-risk, advanced disease at the time of surgery. This may impact the long term oncological outcomes. Our findings suggest a need for better screening strategies to minimize overtreatment while maximizing curative treatment outcomes.

Hariharan Palayapalayam Ganapathi

Director of Clinical Outcomes
Florida Hospital

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    Fikret Onol

    Florida Hospital Global Robotics Institute

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      Travis Rogers

      Florida Hospital Global Robotics Institute

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        Shannon Roof

        Florida Hospital Global Robotics Institute

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          Vipul Patel

          Florida Hospital Global Robotics Institute

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