Re: Anna Lantz, David Bock, Olof Akre, et al. Functional and Oncological Outcomes After Open Versus Robot-assisted Laparoscopic Radical Prostatectomy for Localised Prostate Cancer: 8-Year Follow-up. Eur Urol 2021;80:650–60

2021 ◽  
Author(s):  
Wei Zheng So ◽  
Ziting Wang ◽  
Ho Yee Tiong
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Laparoscopic Radical Prostatectomy ◽  
Robot Assisted ◽  
Oncological Outcomes ◽  
Open Versus

Comparison of Treatment Outcomes between Laparoscopic and Robot-Assisted Laparoscopic Radical Prostatectomy in Clinically Localized Prostate Cancer, A Single-Surgeon Experience

2020 ◽  
Vol 103 (12) ◽  
pp. 1300-1308
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Laparoscopic Radical Prostatectomy ◽  
Localized Prostate Cancer ◽  
Robot Assisted ◽  
Oncological Outcomes ◽  
Estimated Blood Loss ◽  
Surgeon Experience ◽  
Potency Rate

Objective: To compare the treatment outcomes between laparoscopic radical prostatectomy (LRP) and robot-assisted laparoscopic radical prostatectomy (RALP) in clinically localized prostate cancer in a tertiary care hospital in Thailand by a single-surgeon experience. Materials and Methods: Between January 2013 and June 2019, 171 patients with clinically localized prostate cancer underwent minimally invasive radical prostatectomy. These were LRP in 62 patients and RALP in 109 patients. All clinical data were retrospectively reviewed. Patient demographic data, perioperative parameters, pathological reports, oncological outcomes, and functional outcomes including continence and potency rate at 1, 3, 6, and 12 months were compared between groups. Results: Patients in the RALP group were significantly younger (p=0.03) and had a shorter follow-up period (p=0.004). The estimated blood loss was significantly lower in the RALP group (p=0.001). There were no significant differences in intraoperative and 30-day postoperative complications. Pathological results and overall positive surgical margin rate (PSM) were not significantly different. In pT3 patients, PSM was significantly lower in the RALP group (p=0.045). Oncological outcomes were not different in term of biochemical recurrence (BCR) rate (p=0.3), median time to BCR (p=0.45), BCR-free survival (p=0.81), and overall survival (p=0.99). The continence rate was significantly better in the RALP group in every period after surgery (p=0.01, <0.001, 0.001, and p=0.02 at 1, 3, 6 and 12 months, respectively). The potency rate who performed bilateral neurovascular bundles sparing was not different between groups. Conclusion: RALP provided a significant improvement of continence recovery and PSM rate in non-organ confined disease. Estimated blood loss was significantly lower among the RALP patient. Larger numbers of patients with longer follow-up will justify proofing these findings. Keywords: Laparoscopic surgery, Robot-assisted surgery, Radical prostatectomy, Prostate cancer

scholarly journals Retzius-sparing robot-assisted laparoscopic radical prostatectomy: functional and early oncologic results in aggressive and locally advanced prostate cancer

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Joanne Nyaboe Nyarangi-Dix ◽  
Magdalena Görtz ◽  
Georgi Gradinarov ◽  
Luisa Hofer ◽  
Viktoria Schütz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Postoperative Radiotherapy ◽  
Locally Advanced ◽  
Laparoscopic Radical Prostatectomy ◽  
Oncologic Outcomes ◽  
Robot Assisted

Abstract Background Retzius-sparing robot-assisted laparoscopic radical prostatectomy (rsRARP) allows entire prostatectomy procedure via the pouch of Douglas. In low- and intermediate-risk prostate cancer (PCa) there is level 1 evidence that the Retzius-sparing approach impacts early continence recovery. Since specific data on aggressive and locally advanced cancer is lacking and avoiding rsRARP is presently suggested, we investigated urinary and sexual recovery, perioperative complications and early oncologic outcomes after rsRARP in this particular cohort. Methods Prospectively collected data of 50 consecutive men (median age 66 years) with high-risk PCa who underwent rsRARP in a single institution was analysed retrospectively. The follow-up for all patients was 12 months after surgery. Results 3 vs. 12 months after surgery, 82% vs. 98% of men used no pad or one safety pad and 50% vs. 72% used no pad. 89% of patients did not observe a decline of continence if postoperative radiotherapy was carried out. Considering the 17 preoperatively potent patients who underwent bi- or unilateral nerve-sparing surgery, 41% reported their first sexual intercourse within 1 year after rsRARP. 84% of patients had ≥pT3a disease and 42% positive surgical margins. A lymphadenectomy was done in 94% of patients with a median lymph node removal of 15 and lymph node metastasis in 13%. 34% underwent adjuvant radiotherapy and 22% adjuvant androgen deprivation therapy (ADT). 1-year recurrence-free survival was 96%, including 25% of patients on adjuvant or salvage ADT. Conclusions RsRARP in high-risk PCa is feasible and results in excellent continence rates, even after postoperative radiotherapy. The potency rates are promising but need further clarification in larger cohorts. Reliable oncologic outcomes require longterm follow-up and are awaited.

scholarly journals Robot-Assisted vs. Laparoscopic Radical Prostatectomy for Immediate- and High-Risk Localized Prostate Cancer: A Propensity-Score Matched Analysis

2021 ◽  
Author(s):  
Deng Wen ◽  
Zhang Cheng ◽  
Jiang Hao ◽  
Li Yulei ◽  
Liu Xiaoqiang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Propensity Score ◽  
Lower Risk ◽  
Laparoscopic Radical Prostatectomy ◽  
Localized Prostate Cancer ◽  
Robot Assisted ◽  
Grade Ii

Abstract Background To evaluate the functional and oncological efficacy of robot-assisted radical prostatectomy (RARP) and laparoscopic radical prostatectomy (LRP) for immediate- and high-risk localized prostate cancer (PCa). Methods 232 patients bearing immediate- and high-risk localized PCa between January 2016 and October 2019 were enrolled according to the inclusion criteria. The perioperative, functional and oncological outcomes were compared between the RARP and LRP groups after applying the propensity-score matching (PM) (1:1) method, which were employed to attenuate the impact of the potential baseline confounders. Results In all, except for 10 patients without a suitable pair, the remaining patients in the LRP group were successfully matched to 85 patients in the RARP arm. All differences in preoperative variables turned to be insignificant after PM. Within the matched cohort, no open conversion was required in both groups. The RARP group was corrected with a significantly shorter mean operative time than the LRP group (p < 0.001). Patients in the RARP arm were also at a lower risk of ≤ Grade II complications than those in the LRP group (p = 0.036). Meanwhile, the proportions of transfusion and ≥ Grade II complications in the RARP group were similar to that in the LRP group (p = 0.192 and p = 1.000, respectively). No significant differences regarding the mean estimated blood loss, rates of pT3 disease and positive surgical margin, median specimen Gleason score and hospital stay length existed between the two groups. RARP vs. LRP tended to a significantly higher percentage of urinary continence at the removal of catheter (p = 0.031), postoperative 6 months (p = 0.043), and last follow-up (p = 0.046). Significant differences were also found between the RARP and LRP arms in erectile function at postoperative 6 months and last follow-up (p = 0.013 and p = 0.009, respectively). The statistical comparability between the two groups was observed in biochemical recurrence-free survival (p = 0.228). Conclusions For surgically managing immediate- and high-risk localized PCa, RARP tended to a lower risk of ≤ Grade II complications and superior functional preservation without cancer control being compromised when comparing with LRP.

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