Feasibility of robot-assisted radical prostatectomy in elderly patients: Comparative analysis of the perisurgical/oncological outcomes with younger patients.

Abstract

111 Background: Robot-assisted radical prostatectomy (RARP) has become one of standard treatments for localized prostate cancer. However, a feasibility of RARP in high elderly patients has not been clear yet. We performed a comparative analysis of peri-surgical / oncological outcomes for younger and elder patients underwent RARP. Methods: We reviewed and compared our 631 consecutive patients who underwent RARP from 9/2012 to 6/2016 for peri-surgical outcomes, including surgical times, blood loss, complications, pathological findings, continence recovery, and oncological outcomes stratified by age less than 75 and over 75 years. Results: In our cohort, 555 men were age less than 75 and 76 men were ≥75. Preoperative parameters (age, PSA, Gleason score) were similar in both younger and high elder groups. Operative time (median: 180 vs. 180 minutes) and estimated blood loss were similar in both groups. One of elder patients (1.4%) needed transfusion. Peri/post-operative complications over grade 3 were 0.9% in younger group and 1.4% in elder group. No case needed intra-operative open conversion. Surgical positive margin rates in organ-confined (pT2) disease were also similar (13.4%, younger vs. 17.9%, elder). Continence at 3 months was 73% in elder patients as opposed to 77% in younger patients. Biochemical recurrences in short follow-up period (median 11.1 vs. 11.0 months) were observed 7.9% in elder patients as opposed 8.3% in younger patients. Conclusions: In our study, although urinary continence recovery in high elderly patients might show a short delay, RARP in high elderly patients was relatively safe and yielded good oncologic results. RARP is feasible even in elderly patients.