Comparative Outcomes of Robotic Radical Prostatectomy in Patients with Locally Advanced Prostate Cancer
The effectiveness of radical prostatectomy alone for locally advanced prostate cancer is controversial owing to an increased complication rate and treatment-related morbidity. With technical advances and refinements in surgical techniques, robotic-assisted radical prostatectomy (RARP) has improved t...
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MDPI AG
2022-12-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/12/1820 |
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| author | Po-I Li Szu-Ju Chen Yung-Hsiang Chen Wen-Chi Chen Chi-Ping Huang |
| author_facet | Po-I Li Szu-Ju Chen Yung-Hsiang Chen Wen-Chi Chen Chi-Ping Huang |
| author_sort | Po-I Li |
| collection | DOAJ |
| description | The effectiveness of radical prostatectomy alone for locally advanced prostate cancer is controversial owing to an increased complication rate and treatment-related morbidity. With technical advances and refinements in surgical techniques, robotic-assisted radical prostatectomy (RARP) has improved the outcomes of patients with locally advanced prostate cancer. RARP therefore plays a role in the treatment of locally advanced prostate cancer. In this study, we enrolled a total of 76 patients with pathologic stage pT3a, pT3b, pT4, or pN1. All patients were followed from surgery to June 2022, and their characteristics, perioperative outcomes, complications, adjuvant therapies and outcomes were analyzed. The median age of the patients was 69 years, and the initial PSA level was 20.5 (IQR 10.8–31.6) ng/mL. The median operative time was 205 (IQR 182–241) minutes. Sixty-six patients (86.8%) regained continence within 1 year, and the continence rate within 3 years of follow-up was 90.8% (69 patients). The overall survival rate was 100%. Twenty-two patients had BCR, of whom 13 received salvage androgen deprivation therapy (ADT), 2 received salvage external beam radiation therapy (EBRT) alone, and 7 received combined ADT and EBRT. No patient had disease progression to castration-resistant prostate cancer during a median 36 months of follow-up after salvage therapy. Our results suggest that RARP can also decrease tumor burden and allow for accurate and precise pathological staging with the need for subsequent treatment. Therefore, we recommend that RARP represents a well-standardized, safe, and oncologically effective option for patients with locally advanced prostate cancer. |
| first_indexed | 2024-03-09T16:07:19Z |
| format | Article |
| id | doaj.art-2e79dd87b9ea45f4b63d60731a8f8975 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T16:07:19Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-2e79dd87b9ea45f4b63d60731a8f89752023-11-24T16:33:18ZengMDPI AGMedicina1010-660X1648-91442022-12-015812182010.3390/medicina58121820Comparative Outcomes of Robotic Radical Prostatectomy in Patients with Locally Advanced Prostate CancerPo-I Li0Szu-Ju Chen1Yung-Hsiang Chen2Wen-Chi Chen3Chi-Ping Huang4Department of Urology, China Medical University Hospital, Taichung 40447, TaiwanDivision of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung 40705, TaiwanGraduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, TaiwanDepartment of Urology, China Medical University Hospital, Taichung 40447, TaiwanDepartment of Urology, China Medical University Hospital, Taichung 40447, TaiwanThe effectiveness of radical prostatectomy alone for locally advanced prostate cancer is controversial owing to an increased complication rate and treatment-related morbidity. With technical advances and refinements in surgical techniques, robotic-assisted radical prostatectomy (RARP) has improved the outcomes of patients with locally advanced prostate cancer. RARP therefore plays a role in the treatment of locally advanced prostate cancer. In this study, we enrolled a total of 76 patients with pathologic stage pT3a, pT3b, pT4, or pN1. All patients were followed from surgery to June 2022, and their characteristics, perioperative outcomes, complications, adjuvant therapies and outcomes were analyzed. The median age of the patients was 69 years, and the initial PSA level was 20.5 (IQR 10.8–31.6) ng/mL. The median operative time was 205 (IQR 182–241) minutes. Sixty-six patients (86.8%) regained continence within 1 year, and the continence rate within 3 years of follow-up was 90.8% (69 patients). The overall survival rate was 100%. Twenty-two patients had BCR, of whom 13 received salvage androgen deprivation therapy (ADT), 2 received salvage external beam radiation therapy (EBRT) alone, and 7 received combined ADT and EBRT. No patient had disease progression to castration-resistant prostate cancer during a median 36 months of follow-up after salvage therapy. Our results suggest that RARP can also decrease tumor burden and allow for accurate and precise pathological staging with the need for subsequent treatment. Therefore, we recommend that RARP represents a well-standardized, safe, and oncologically effective option for patients with locally advanced prostate cancer.https://www.mdpi.com/1648-9144/58/12/1820locally advanced prostate cancerrobotic-assisted radical prostatectomyoutcome |
| spellingShingle | Po-I Li Szu-Ju Chen Yung-Hsiang Chen Wen-Chi Chen Chi-Ping Huang Comparative Outcomes of Robotic Radical Prostatectomy in Patients with Locally Advanced Prostate Cancer Medicina locally advanced prostate cancer robotic-assisted radical prostatectomy outcome |
| title | Comparative Outcomes of Robotic Radical Prostatectomy in Patients with Locally Advanced Prostate Cancer |
| title_full | Comparative Outcomes of Robotic Radical Prostatectomy in Patients with Locally Advanced Prostate Cancer |
| title_fullStr | Comparative Outcomes of Robotic Radical Prostatectomy in Patients with Locally Advanced Prostate Cancer |
| title_full_unstemmed | Comparative Outcomes of Robotic Radical Prostatectomy in Patients with Locally Advanced Prostate Cancer |
| title_short | Comparative Outcomes of Robotic Radical Prostatectomy in Patients with Locally Advanced Prostate Cancer |
| title_sort | comparative outcomes of robotic radical prostatectomy in patients with locally advanced prostate cancer |
| topic | locally advanced prostate cancer robotic-assisted radical prostatectomy outcome |
| url | https://www.mdpi.com/1648-9144/58/12/1820 |
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