Journal article
Functional Recovery, Oncologic Outcomes and Postoperative Complications after Robot-Assisted Radical Prostatectomy: An Evidence-Based Analysis Comparing the Retzius Sparing and Standard Approaches
The Journal of urology, Vol.199(5), pp.1210-1217
05/01/2018
DOI: 10.1016/j.juro.2017.11.115
PMID: 29225060
Abstract
Purpose: We report a 1-year update of functional urinary and sexual recovery, oncologic outcomes and postoperative complications in patients who completed a randomized controlled trial comparing posterior (Retzius sparing) with anterior robot-assisted radical prostatectomy.
Materials and Methods: A total of 120 patients with clinically low-intermediate risk prostate cancer were randomized to undergo robot-assisted radical prostatectomy via the posterior and anterior approach in 60 each. Surgery was performed by a single surgical team at an academic institution. An independent third party ascertained urinary and sexual function outcomes preoperatively, and 3, 6 and 12 months after surgery. Oncologic outcomes consisted of positive surgical margins and biochemical recurrence-free survival. Biochemical recurrence was defined as 2 postoperative prostate specific antigen values of 0.2 ng/ml or greater.
Results: Median age of the cohort was 61 years and median followup was 12 months. At 12 months in the anterior vs posterior prostatectomy groups there were no statistically significant differences in the urinary continence rate (0 to 1 security pad per day in 93.3% vs 98.3%, p = 0.09), 24-hour pad weight (median 12 vs 7.5 gm, p = 0.3), erection sufficient for intercourse (69.2% vs 86.5%) or postoperative Sexual Health Inventory for Men score 17 or greater (44.6% vs 44.1%). In the posterior vs anterior prostatectomy groups a nonfocal positive surgical margin was found in 11.7% vs 8.3%, biochemical recurrence-free survival probability was 0.84 vs 0.93 and postoperative complications developed in 18.3% vs 11.7%.
Conclusions: Among patients with clinically low-intermediate risk prostate cancer randomized to anterior (Menon) or posterior (Bocciardi) approach robot-assisted radical prostatectomy the differences in urinary continence seen at 3 months were muted at the 12-month followup. Sexual function recovery, postoperative complication and biochemical recurrence rates were comparable 1 year postoperatively.
Details
- Title: Subtitle
- Functional Recovery, Oncologic Outcomes and Postoperative Complications after Robot-Assisted Radical Prostatectomy: An Evidence-Based Analysis Comparing the Retzius Sparing and Standard Approaches
- Creators
- Mani Menon - Wayne State UniversityDeepansh Dalela - Henry Ford Health SystemMarcus Jamil - Henry Ford Health SystemMireya Diaz - Henry Ford Health SystemChristopher Tallman - Henry Ford Health SystemFiras Abdollah - Henry Ford Health SystemAkshay Sood - Henry Ford Hlth Syst, Vattikuti Urol Inst, Ctr Outcomes Res Analyt & Evaluat, 2799 West Grand Blvd,K-9, Detroit, MI 48202 USALinda Lehtola - Henry Ford Health SystemDavid Miller - University of MichiganWooju Jeong - Henry Ford Health System
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.199(5), pp.1210-1217
- DOI
- 10.1016/j.juro.2017.11.115
- PMID
- 29225060
- NLM abbreviation
- J Urol
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Publisher
- Elsevier
- Number of pages
- 8
- Grant note
- Blue Cross Blue Shield of Michigan (Michigan Urological Surgery Improvement Collaborative)
- Language
- English
- Date published
- 05/01/2018
- Academic Unit
- Urology
- Record Identifier
- 9984949450702771
Metrics
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