Comparative analysis of short - term functional outcomes and quality of life in a prospective series of brachytherapy and Da Vinci robotic prostatectomy

Abstract

Introduction There is a growing interest in achieving higher survival rates with the lowest morbidity in localized prostate cancer (PC) treatment. Consequently, minimally invasive techniques such as low-dose rate brachytherapy (BT) and robotic-assisted prostatectomy (RALP) have been developed and improved. Comparative analysis of functional outcomes and quality of life in a prospective series of 51BT and 42Da Vinci prostatectomies DVMaterials and Methods Comparative analysis of functional outcomes and quality of life in a prospective series of 93 patients with low-risk localized PC diagnosed in 2011. 51patients underwent low-dose rate BT and the other 42 patients RALP. IIEF to assess erectile function, ICIQ to evaluate continence and SF36 test to quality of life wee employed.Results ICIQ at the first revision shows significant differences which favour the BT group, 79% present with continence or mild incontinence, whereas in the DV group 45% show these positive results. Differences disappear after 6 months, with 45 patients (89%) presenting with continence or mild incontinence in the BT group vs. 30 (71%) in the DV group. 65% of patients are potent in the first revision following BT and 39% following DV. Such differences are not significant and cannot be observed after 6 months. No significant differences were found in the comparative analysis of quality of life.Conclusions ICIQ after surgery shows significant differences in favour of BT, which disappear after 6 months. Both procedures have a serious impact on erectile function, being even greater in the DV group. Differences between groups disappear after 6 months.

Radical prostatectomy versus brachytherapy for clinically localized prostate cancer on oncological and functional outcomes: a meta-analysis

“…In the studies, a total of 61,752 patients underwent primary radical treatment, with 45,002 being treated by RP and 16,750 by BT. Further characterization of the included studies is detailed in Table 1 (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). All the studies were published within the last 2 decades.…”

Quality of life in patients who underwent robot‐assisted radical prostatectomy compared with those who underwent low‐dose‐rate brachytherapy

“…Moreover, patients who underwent LDR‐BT had worsened urinary QOL, as shown in the IPSS and urinary irritative/obstructive domain of EPIC. Previous studies reported worse QOL deterioration in the urinary incontinence domain in patients who underwent prostatectomy 12 and RARP, 3,11 including those who underwent bilateral nerve‐sparing RARP 3 versus LDR‐BT. On the other hand, worse QOL deterioration was noted in the urinary irritative/obstructive domain in patients who received LDR‐BT versus prostatectomy 12 and RARP 3,11 .…”

“…Previous studies reported worse QOL deterioration in the urinary incontinence domain in patients who underwent prostatectomy 12 and RARP, 3,11 including those who underwent bilateral nerve‐sparing RARP 3 versus LDR‐BT. On the other hand, worse QOL deterioration was noted in the urinary irritative/obstructive domain in patients who received LDR‐BT versus prostatectomy 12 and RARP 3,11 . Furthermore, in this study, improvement of urinary QOL was also evaluated.…”

“…However, the patient characteristics (age, clinical stage, race, and risk group) differed significantly between patients who underwent RARP or LDR‐BT. Furthermore, in a randomized study by Giberti et al 10 and a prospective study by García‐Sánchez et al, 11 RARP and LDR‐BT were compared in patients with low‐risk prostate cancer. Nevertheless, these investigations were limited to patients with low‐risk prostate cancer and small population.…”

New Isotopes for the Treatment of Pancreatic Cancer in Collaboration With CERN: A Mini Review

“…Few studies have been carried out yet to examine the potential benefits of robotic-assisted brachytherapy. Some studies described brachytherapy through surgery with the Da Vinci System in pigs after thoracoscopic wedge resection ( 53 ) and in patients with prostate ( 54 ) or bladder ( 55 ) cancer. There hasn't been any study using brachytherapy with the Da Vinci System in patients with pancreatic adenocarcinoma so far.…”