Preoperative Predictive Factors for Seminal Vesicle Invasion (pT3b) in Robotic-assisted Radical Prostatectomy.

BACKGROUND/AIM: Robot-assisted radical prostatectomy (RARP) outcomes improve with surgical experience, but preoperative prediction of disease stage is crucial to avoid unexpected T stage upgrades, such as pT3b. This study aimed to identify preoperative predictive factors for pT3b (seminal vesicle invasion) following RARP.

PATIENTS AND METHODS

Out of 299 RARP performed between 2013 and 2020, 246 cases without preoperative hormone therapy were included. Of these, 19 cases (7.7%) were pT3b. T classification was performed using magnetic resonance imaging (MRI), and 12-site prostate biopsies were conducted. Cox proportional hazards, logistic regression analysis, and Kaplan-Meier analyses were used.

RESULTS

The 3-year prostate specific antigen (PSA) recurrence-free survival rate was 87% but significantly lower at 70% for pT3b cases. Multivariate logistic regression analysis identified the International Society of Urological Pathology (ISUP) grade group at biopsy as the only significant preoperative predictor of pT3b.

CONCLUSION

pT3b is associated with increased postoperative biochemical recurrence risk, and ISUP grade group at biopsy serves as a significant preoperative predictive factor for pT3b.