Oncological outcomes after Senhance robot-assisted radical prostatectomy: biochemical recurrence and risk stratification in a large single-centre cohort.

To evaluate biochemical recurrence (BCR) after Senhance robot-assisted radical prostatectomy and identify its predictors. We retrospectively analysed consecutive patients undergoing Senhance radical prostatectomy between November 2019 and March 2025. BCR was defined as a postoperative PSA of 0.2 ng/mL or above, confirmed on a subsequent measurement. Patients whose first postoperative PSA reached this threshold were classified as persistent PSA and excluded. BCR-free survival was estimated and an exploratory score assigned one point each for pT3 stage, grade group 3 or above, positive margin and intraductal carcinoma. Of 824 patients, 813 had evaluable follow-up; 22 (2.7%) had persistent PSA, leaving 791. Median preoperative PSA was 7.3 ng/mL; 276 (34.9%) had pT3 disease and 270 (34.1%) a positive margin. Median follow-up was 26 months and BCR occurred in 88 patients (11.1%). BCR-free survival was 93.5%, 89.6% and 86.9% at 12, 24 and 36 months. Independent predictors were preoperative PSA (HR 1.70), grade group (HR 1.83), pT3b stage (HR 2.22), positive margin (HR 2.04), lymphovascular invasion (HR 2.00) and intraductal carcinoma (HR 2.00). Twenty-four-month BCR-free survival ranged from 99.7% with no adverse factors to 55.8% with three or more. Short- to intermediate-term biochemical control was within the range reported in contemporary RARP series, although cross-platform comparison is not possible without a comparator. Recurrence was associated with established adverse pathology, and an exploratory four-factor score separated patients into markedly different risk groups, pending external validation.