Robot-Assisted Radical Prostatectomy in High-Risk Prostate Cancer

Background. Prostate cancer (PC) is subdivided into risk categories according to patient prognosis. High-risk disease was previously typified by a higher risk of metastasis and mortality, which implied comprehensive treatment. Manifold studies have concluded that surgery is a key measure in such cases, even as monotherapy. Open radical prostatectomy (RP) was routinely performed in most high-risk PC patients until robot-assisted radical prostatectomy (RARP) had become a reasonable choice as improving outcomes in low- and intermediate-risk PC patients. Reliable RARP assessments in high-risk PC are still lacking. Th e review summarises published data on functional and oncological RARP outcomes in high-risk PC patients and analyses surgical inpatient cases at the BSMU Clinic for 2018—2021.Materials and methods. The surgical outcomes in high-risk PC inpatients were analysed retrospectively at the BSMU Clinic for 2018—June 2021. Among 540 RARPs performed, 199 PC patients were identified as high-risk in the D’Amico criteria.Results and discussion. Mean operation time was 100 min, blood transfusion rate — 3.5 %. Bladder catheterisation time was 5 days, average hospital stay — 7.1 days.Conclusion. RARP may facilitate optimal therapeutic efficacy and favour postoperative recovery as monotherapy or the first step in a multimodal treatment of high-risk PC patients.

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Predictive factors for short-term biochemical recurrence-free survival after robot-assisted laparoscopic radical prostatectomy in high-risk prostate cancer patients

International Journal of Clinical Oncology ◽

10.1007/s10147-019-01445-7 ◽

2019 ◽

Vol 24 (9) ◽

pp. 1099-1104 ◽

Cited By ~ 3

Author(s):

Mitsugu Kanehira ◽

Ryo Takata ◽

Shuhei Ishii ◽

Akito Ito ◽

Daiki Ikarashi ◽

...

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Radical Prostatectomy ◽

Biochemical Recurrence ◽

Recurrence Free Survival ◽

Robot Assisted ◽

Short Term ◽

Free Survival ◽

High Risk Prostate Cancer ◽

Risk Prostate Cancer

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Salvage robot-assisted radical prostatectomy (sRARP) for radiation resistant prostate cancer in a group of initially high risk patients

Nepalese Journal of Cancer ◽

10.3126/njc.v1i1.25628 ◽

2017 ◽

Vol 1 (1) ◽

pp. 21-27

Author(s):

Nirmal Lamichhane ◽

Adam S. Dowrick ◽

Ulrika Axcrona ◽

Bjørn Brennhovd ◽

Sophie D. Fosså ◽

...

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Radical Prostatectomy ◽

High Frequency ◽

Salvage Treatment ◽

Rectal Injury ◽

Robot Assisted ◽

Radiation Resistant ◽

Risk Patients

Introduction: Salvage robot-assisted radical prostatectomy (sRARP) is seen as an attractive option for salvage treatment of radiation therapy -recurrent prostate cancer (PC), thanks in part to the good visualisation that is possible using this modality. However, the results of fewer than 200 salvage sRARPs have been published in the literature. We report the outcomes in a cohort of initially high risk patients of robot-assisted radical prostatectomy as salvage local therapy for radiation-resistant PC in a Scandinavian healthcare setting. Materials and methods: A retrospective review of the charts of all patients who underwent sRARP for biochemical failure (BCF) after primary radiation treatment for localised PC at a single institution was performed. Results: Twenty-two patients, median age 67 years (range 57 to 72), had sRARP performed between June 2008 to July 2013. A median follow-up of 26 months (range 2 to 63) was observed. Perioperative complications occurred in 4 patients (18%), with one patient sustaining a rectal injury. Histo-pathological diagnosis was pT2 in three, pT3a in five, pT3b in twelve and pTx in one patient. Ten patients (45%) had a positive surgical margin (PSM). At follow-up, 54 % of patients were free of biochemical progression and 41% were continent. Conclusions: We showed that salvage RARP is technically feasible in a cohourt of patients with predominantly high risk disease. This study adds to the limited data already in the literature, demonstrating the high frequency of locally advanced (pT3b) PC, a patient group that is usually not included in salvage treatments, as e.g. high frequency ultrasound or salvage brachytherapy. Further, given that the historical barriers to salvage RP with higher rates of rectal injury and poor urinary control no longer seem to be applicable in the modern era, we think that more patients should be considered candidates for this potentially curative salvage treatment of radiation-resistant PC. However, long-term follow-up is needed to confirm if the additional burden on these patients confers to oncological control following the procedure.

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