Robotic radical prostatectomy following renal transplant

Background: circulating levels of lymphocytes, platelets and neutrophils have been identified as factors related to unfavorable clinical outcome for many solid tumors. The aim of this cohort study is to evaluate and validate the use of the Prostatic Systemic Inflammatory Markers (PSIM) score in predicting and improving the detection of clinically significant prostate cancer (csPCa) in men undergoing robotic radical prostatectomy for low-risk prostate cancer who met the inclusion criteria for active surveillance. Methods: we reviewed the medical records of 260 patients who fulfilled the inclusion criteria for active surveillance. We performed a head-to-head comparison between the histological findings of specimens after radical prostatectomy (RP) and prostate biopsies. The PSIM score was calculated on the basis of positivity according to cutoffs (neutrophil-to-lymphocyte ratio (NLR) 2.0, platelets-to-lymphocyte ratio (PLR) 118 and monocyte-to-lymphocyte-ratio (MLR) 5.0), with 1 point assigned for each value exceeding the specified threshold and then summed, yielding a final score ranging from 0 to 3. Results: median NLR was 2.07, median PLR was 114.83, median MLR was 3.69. Conclusion: we found a significantly increase in the rate of pathological International Society of Urological Pathology (ISUP) ≥ 2 with the increase of PSIM. At the multivariate logistic regression analysis adjusted for age, prostate specific antigen (PSA), PSA density, prostate volume and PSIM, the latter was found the sole independent prognostic variable influencing probability of adverse pathology.

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Re: Vinayak G. Wagaskar, Ankur Mittal, Stanislaw Sobotka, et al. Hood Technique for Robotic Radical Prostatectomy—Preserving Periurethral Anatomical Structures in the Space of Retzius and Sparing the Pouch of Douglas, Enabling Early Return of Continence Without Compromising Surgical Margin Rates. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2020.09.044

European Urology ◽

10.1016/j.eururo.2021.02.026 ◽

2021 ◽

Author(s):

Nikolaos Grivas ◽

Paolo Dell’Oglio ◽

Ruben De Groote ◽

Filippo Turri ◽

Charalampos Mamoulakis ◽

...

Keyword(s):

Radical Prostatectomy ◽

Surgical Margin ◽

Anatomical Structures ◽

Robotic Radical Prostatectomy ◽

Early Return ◽

Pouch Of Douglas

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Radical prostatectomy outcomes in renal transplant recipients: a retrospective case series of Thai patients

BMC Urology ◽

10.1186/s12894-021-00862-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kun Sirisopana ◽

Pocharapong Jenjitranant ◽

Premsant Sangkum ◽

Kittinut Kijvikai ◽

Suthep Pacharatakul ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Renal Transplant ◽

Operative Time ◽

Case Series ◽

Urinary Continence ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Estimated Blood Loss ◽

The Mean

Abstract Background The incidence of prostate cancer in renal transplant recipients (RTR) is similar to the general population. Radical prostatectomy (RP) is the standard of care in the management of clinically localized cancer, but is considered complicated due to the presence of adhesions, and the location of transplanted ureter/kidney. To date, a few case series or studies on RP in RTR have been published, especially in Asian patients. This study aimed to evaluate the efficacy and safety and report the experience with RP on RTR. Methods We retrospectively reviewed data of 1270 patients who underwent RP from January 2008 to March 2020, of which 5 patients were RTR. All available baseline characteristics, perioperative and postoperative data (operative time, estimated blood loss (EBL), complications, length of hospital stay, complication), pathological stage, Gleason score, surgical margin status, and pre/postoperative creatinine were reviewed. Results Of the 5 RTR who underwent RPs (1 open radical prostatectomy (ORP), 1 laparoscopic radical prostatectomy (LRP), 2 robotic-assisted laparoscopic radical prostatectomies (RALRP), and 1 Retzius-sparing RALRP (RS-RALRP)) prostatectomy, the mean age (± SD) was 70 (± 5.62) years. In LRP and RALRP cases, the standard ports were moved slightly medially to prevent graft injury. The mean operative time ranged from 190 to 365 min. The longest operative time and highest EBL (630 ml) was the ORP case due to severe adhesion in Retzius space. For LRP and RALRP cases, the operative times seemed comparable and had EBL of ≤ 300 ml. All RPs were successful without any major intra-operative complication. There was no significant change in graft function. The restorations of urinary continence were within 1 month in RS-RALRP, approximately 6 months in RALRP, and about 1 year in ORP and LRP. Three patients with positive surgical margins had prostate-specific antigen (PSA) persistence at the first follow-up and 1 had later PSA recurrence. Two patients with negative margins were free from biochemical recurrence at 47 and 3 months after their RP. Conclusions Our series suggested that all RP techniques are safe and feasible mode of treatment for localized prostate cancer in RTR.

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