450 PATTERNS OF BIOCHEMICAL RECURRENCE AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY. RESULTS OF PATIENTS WITH A MINIMUM FOLLOW-UP OF 5 YEARS

Abstract Various neurovascular bundle-sparing techniques have been introduced to maximize recovery of erectile function after robot-assisted radical prostatectomy (RARP). The clipless intrafascial neurovascular bundle-sparing technique aims to preserve periprostatic structures and neurovascular bundles as much as possible by avoiding clipping of the vascular pedicles. This study reports 1-year functional and oncologic outcomes and postoperative complications in 105 patients with intact preoperative erectile function who underwent a modified clipless intrafascial neurovascular bundle-sparing RARP. Intact erectile function was defined as score ≥ 21 on the Sexual Health Inventory for Men questionnaire or ability to have sexual intercourse. Median follow-up was 26.5 months (IQR 15.25–48). Postoperative erectile function recovery rates were 71.4%, 81.9%, 88.6%, 92.4%, and 94.3% at 1, 3, 6, 9, and 12 months, respectively. The rate of positive surgical margins was 16.2% overall and 11.8% in patients with stage pT2 disease. The biochemical recurrence rate was 6.7% overall. The modified clipless intrafascial neurovascular bundle-sparing technique is safe and feasible and can achieve excellent recovery of erectile function after RARP. Further large-scale prospective comparative studies are warranted.

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The impact of length and location of positive margins in predicting biochemical recurrence after robot-assisted radical prostatectomy with a minimum follow-up of 5 years

BJU International ◽

10.1111/bju.12483 ◽

2014 ◽

Vol 115 (1) ◽

pp. 106-113 ◽

Cited By ~ 34

Author(s):

Prasanna Sooriakumaran ◽

Achilles Ploumidis ◽

Tommy Nyberg ◽

Mats Olsson ◽

Olof Akre ◽

...

Keyword(s):

Radical Prostatectomy ◽

Biochemical Recurrence ◽

Robot Assisted ◽

Positive Margins ◽

The Impact

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Effect of Dexmedetomidine on Biochemical Recurrence in Patients after Robot-Assisted Laparoscopic Radical Prostatectomy: A Retrospective Study

Journal of Personalized Medicine ◽

10.3390/jpm11090912 ◽

2021 ◽

Vol 11 (9) ◽

pp. 912

Author(s):

Young Chul Yoo ◽

Won Sik Jang ◽

Ki Jun Kim ◽

Jung Hwa Hong ◽

Sunmo Yang ◽

...

Keyword(s):

Radical Prostatectomy ◽

Biochemical Recurrence ◽

Radiographic Progression ◽

Cox Regression ◽

Laparoscopic Radical Prostatectomy ◽

Cancer Type ◽

Robot Assisted ◽

Cox Regression Analysis ◽

Number Of Patients

The usage of dexmedetomidine during cancer surgery in current clinical practice is debatable, largely owing to the differing reports of its efficacy based on cancer type. This study aimed to investigate the effects of dexmedetomidine on biochemical recurrence (BCR) and radiographic progression in patients with prostate cancer, who have undergone robot-assisted laparoscopic radical prostatectomy (RALP). Using follow-up data from two prospective randomized controlled studies, BCR and radiographic progression were compared between individuals who received dexmedetomidine (n = 58) and those who received saline (n = 56). Patients with complete follow-up records between July 2013 and June 2019 were enrolled in this study. There were no significant between-group differences in the number of patients who developed BCR and those who showed positive radiographic progression. Based on the Cox regression analysis, age (p = 0.015), Gleason score ≥ 8 (p < 0.001), and pathological tumor stage 3a and 3b (both p < 0.001) were shown to be significant predictors of post-RALP BCR. However, there was no impact on the dexmedetomidine or control groups. Low-dose administration of dexmedetomidine at a rate of 0.3–0.4 μg/kg/h did not significantly affect BCR incidence following RALP. In addition, no beneficial effect was noted on radiographic progression.

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Effect of open versus robot-assisted laparoscopic radical prostatectomy on cancer control in patients with clinically localized prostate cancer: Prospective analysis of 1,014 consecutive patients.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.5_suppl.80 ◽

2012 ◽

Vol 30 (5_suppl) ◽

pp. 80-80

Author(s):

Adrian Stuart Fairey ◽

Niels Jacobsen ◽

Don Voaklander ◽

Eric Estey

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Surgical Approach ◽

Biochemical Recurrence ◽

Cancer Control ◽

Laparoscopic Radical Prostatectomy ◽

Localized Prostate Cancer ◽

Prospective Analysis ◽

Robot Assisted

80 Background: There are limited prospective data comparing outcomes of Open Radical Prostatectomy (ORP) and Robot-Assisted Laparoscopic Radical Prostatectomy (RALRP) for clinically localized prostate cancer. Our aim was to compare ORP and RALRP with respect to cancer control outcomes. Methods: A prospective analysis of data from the University of Alberta Radical Prostatectomy Database was performed. Between September 2007 and August 2010, 1019 consecutive men underwent radical prostatectomy for clinically localized prostate cancer. The surgical approach was selected by the surgeon. The outcomes were biochemical recurrence (BCR) and positive surgical margins (PSM). BCR was defined as a PSA ≥ 0.1 ng/ml followed by a subsequent confirmatory value or initiation of salvage therapy. PSM was defined as the presence of cancer at the inked margin in the radical prostatectomy specimen. The Kaplan-Meier method was used to estimate biochemical recurrence free survival (BCRFS). Univariable and multivariable analyses were used to determine the association between surgical approach and outcomes. Results: Data were evaluable for 1014 out of 1019 patients. 204 patients underwent ORP and 810 patients underwent RALRP. The median follow-up duration was 21 months (IQR 12 to 29). Baseline characteristics were similar between the groups. In univariable analysis, 3-year BCRFS (90.6% versus 88.9%), overall PSM (26.5% versus 28.8%), and stage-stratified PSM (pT2: 19.9% versus 21.8%; pT3: 40.6% versus 49.1%) did not differ between the groups (all comparisons p>0.05). In multivariable analysis, surgical approach was not independently associated with BCR (HR 0.77, 95% CI 0.43 to 1.37, p=0.37) or PSM (OR 1.2, 95% CI 0.80 to 1.67, p=0.44). Conclusions: ORP and RALRP provided comparable short-term oncologic efficacy. Extended follow-up of the prospective cohort is needed to confirm these preliminary findings.

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