Robot Partial Prostatectomy for Anterior Cancer: Long-term Functional and Oncological Outcomes at 7 Years
Partial prostatectomy has been described as an alternative to focal ablation therapy for the management of localized low- to intermediate-risk prostate cancer. This report aims to describe the long-term outcomes in a series of 28 men (2000–2022) who underwent robotic-assisted anterior partial prosta...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | European Urology Open Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666168323003713 |
| _version_ | 1827825428268580864 |
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| author | Arnauld Villers Denis Seguier Philippe Puech Georges-Pascal Haber Mihir M. Desai Sebastien Crouzet Xavier Leroy Julien Labreuche Inderbir S. Gill Jonathan Olivier |
| author_facet | Arnauld Villers Denis Seguier Philippe Puech Georges-Pascal Haber Mihir M. Desai Sebastien Crouzet Xavier Leroy Julien Labreuche Inderbir S. Gill Jonathan Olivier |
| author_sort | Arnauld Villers |
| collection | DOAJ |
| description | Partial prostatectomy has been described as an alternative to focal ablation therapy for the management of localized low- to intermediate-risk prostate cancer. This report aims to describe the long-term outcomes in a series of 28 men (2000–2022) who underwent robotic-assisted anterior partial prostatectomy (APP) for anteriorly located tumors entirely or partially within the anterior fibromuscular stroma. The median follow-up is 7 yr (interquartile range [IQR]: 4.2–8). The median prostate-specific antigen (PSA) before APP was 9.6 (6–11). Continence remained uninterrupted in 92% of patients. Erectile function without drug remained uninterrupted in 69%. The median nadir PSA after APP was 0.36 ng/ml (IQR: 0.25–0.60). Cancer recurrence at biopsies at the margins of the primary cancer resected area in case of a PSA elevation was observed in eight patients and led to salvage completion robotic radical prostatectomy at a median time of 3.25 yr (IQR: 2.4–6). Freedom from post-APP cancer recurrence at 7 yr was 62.7% (35.0–81.3%). Pre-APP tumor volume at magnetic resonance imaging (MRI) and volume of grade 4/5 were predictive of recurrence. Freedom from biochemical recurrence after completion radical prostatectomy at 7 yr was 94.7% (68.1–99.3%). All 28 patients are alive. No one had systemic treatment or metastases. These results confirm our initial report of robotic APP with good functional results and acceptable oncological results. The use of the inclusion criteria of pre-APP tumor volume at MRI <3 cc may decrease the risk of recurrence. Patient summary: In this report, we looked at outcomes for infrequent cases of anterior prostate cancer treated with anterior partial prostatectomy, an uncommon surgical procedure as an alternative to in situ focal ablation therapy, to better preserve functional outcomes as compared with whole gland therapy. We found that functional outcomes of uninterrupted continence and erectile function were good. Out of 28 patients, eight had recurrence in the remaining prostate and were treated with a second surgical procedure, radical prostatectomy, which was feasible. We conclude that this new technique is feasible with good functional results and acceptable oncological results, which can be shared with the patients. |
| first_indexed | 2024-03-12T02:49:56Z |
| format | Article |
| id | doaj.art-191fc6b383dd4657a28be07b0502bcb1 |
| institution | Directory Open Access Journal |
| issn | 2666-1683 |
| language | English |
| last_indexed | 2024-03-12T02:49:56Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Urology Open Science |
| spelling | doaj.art-191fc6b383dd4657a28be07b0502bcb12023-09-04T04:10:39ZengElsevierEuropean Urology Open Science2666-16832023-09-01551114Robot Partial Prostatectomy for Anterior Cancer: Long-term Functional and Oncological Outcomes at 7 YearsArnauld Villers0Denis Seguier1Philippe Puech2Georges-Pascal Haber3Mihir M. Desai4Sebastien Crouzet5Xavier Leroy6Julien Labreuche7Inderbir S. Gill8Jonathan Olivier9Department of Urology, CHU Lille, Univ. Lille, Lille, France; UMR9020-U1277 – CANTHER, CNRS, Inserm, Institut Pasteur de Lille, CHU Lille, Univ. Lille, Lille, France; Corresponding author. Department of Urology, CHU Lille, Université de Lille, F-59000 Lille, France. Tel. +33 3 20 44 42 35; Fax: +33 3 20 44 42 35.Department of Urology, CHU Lille, Univ. Lille, Lille, France; UMR9020-U1277 – CANTHER, CNRS, Inserm, Institut Pasteur de Lille, CHU Lille, Univ. Lille, Lille, FranceDepartment of Radiology, CHU Lille, Univ. Lille, Lille, FranceGlickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USACatherine & Joseph Aresty Department of Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USADepartment of Urology, Edouard Herriot Hospital, University of Lyon, Lyon, FranceDepartment of Pathology, CHU Lille, Université de Lille, Lille, FranceDepartment of Biostatistics, CHU Lille, Lille, France; ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, CHU Lille, University of Lille, Lille, FranceCatherine & Joseph Aresty Department of Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USADepartment of Urology, CHU Lille, Univ. Lille, Lille, France; UMR9020-U1277 – CANTHER, CNRS, Inserm, Institut Pasteur de Lille, CHU Lille, Univ. Lille, Lille, FrancePartial prostatectomy has been described as an alternative to focal ablation therapy for the management of localized low- to intermediate-risk prostate cancer. This report aims to describe the long-term outcomes in a series of 28 men (2000–2022) who underwent robotic-assisted anterior partial prostatectomy (APP) for anteriorly located tumors entirely or partially within the anterior fibromuscular stroma. The median follow-up is 7 yr (interquartile range [IQR]: 4.2–8). The median prostate-specific antigen (PSA) before APP was 9.6 (6–11). Continence remained uninterrupted in 92% of patients. Erectile function without drug remained uninterrupted in 69%. The median nadir PSA after APP was 0.36 ng/ml (IQR: 0.25–0.60). Cancer recurrence at biopsies at the margins of the primary cancer resected area in case of a PSA elevation was observed in eight patients and led to salvage completion robotic radical prostatectomy at a median time of 3.25 yr (IQR: 2.4–6). Freedom from post-APP cancer recurrence at 7 yr was 62.7% (35.0–81.3%). Pre-APP tumor volume at magnetic resonance imaging (MRI) and volume of grade 4/5 were predictive of recurrence. Freedom from biochemical recurrence after completion radical prostatectomy at 7 yr was 94.7% (68.1–99.3%). All 28 patients are alive. No one had systemic treatment or metastases. These results confirm our initial report of robotic APP with good functional results and acceptable oncological results. The use of the inclusion criteria of pre-APP tumor volume at MRI <3 cc may decrease the risk of recurrence. Patient summary: In this report, we looked at outcomes for infrequent cases of anterior prostate cancer treated with anterior partial prostatectomy, an uncommon surgical procedure as an alternative to in situ focal ablation therapy, to better preserve functional outcomes as compared with whole gland therapy. We found that functional outcomes of uninterrupted continence and erectile function were good. Out of 28 patients, eight had recurrence in the remaining prostate and were treated with a second surgical procedure, radical prostatectomy, which was feasible. We conclude that this new technique is feasible with good functional results and acceptable oncological results, which can be shared with the patients.http://www.sciencedirect.com/science/article/pii/S2666168323003713ProstatectomyFocal therapyProstate cancerMagnetic resonance imagingImage-guided interventionMinimally invasive surgery |
| spellingShingle | Arnauld Villers Denis Seguier Philippe Puech Georges-Pascal Haber Mihir M. Desai Sebastien Crouzet Xavier Leroy Julien Labreuche Inderbir S. Gill Jonathan Olivier Robot Partial Prostatectomy for Anterior Cancer: Long-term Functional and Oncological Outcomes at 7 Years European Urology Open Science Prostatectomy Focal therapy Prostate cancer Magnetic resonance imaging Image-guided intervention Minimally invasive surgery |
| title | Robot Partial Prostatectomy for Anterior Cancer: Long-term Functional and Oncological Outcomes at 7 Years |
| title_full | Robot Partial Prostatectomy for Anterior Cancer: Long-term Functional and Oncological Outcomes at 7 Years |
| title_fullStr | Robot Partial Prostatectomy for Anterior Cancer: Long-term Functional and Oncological Outcomes at 7 Years |
| title_full_unstemmed | Robot Partial Prostatectomy for Anterior Cancer: Long-term Functional and Oncological Outcomes at 7 Years |
| title_short | Robot Partial Prostatectomy for Anterior Cancer: Long-term Functional and Oncological Outcomes at 7 Years |
| title_sort | robot partial prostatectomy for anterior cancer long term functional and oncological outcomes at 7 years |
| topic | Prostatectomy Focal therapy Prostate cancer Magnetic resonance imaging Image-guided intervention Minimally invasive surgery |
| url | http://www.sciencedirect.com/science/article/pii/S2666168323003713 |
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