Oncological and functional outcomes in patients over 70 years of age treated with robotic radical prostatectomy: a propensity-matched analysis

Gurung, Pratik; Wang, Bokai; Hassig, Stephen; Wood, Jasmine; Ellis, Elizabeth; Feng, Changyong; Ghazi, Ahmed; Joseph, Jean

doi:10.1007/s00345-020-03304-x

Cited by 19 publications

(24 citation statements)

References 26 publications

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“…Furthermore, substantial evidence has emerged demonstrating the safety and feasibility of RP for appropriately selected older men with satisfactory oncological outcomes. 7,12–17…”

mentioning

confidence: 99%

“…Evidence demonstrating the effect of age on post-RP functional outcomes is conflicting. 5,13–21 Our review of the literature revealed the following deficiencies: 1) no multi-institutional studies; 2) heterogenous continence definitions based on pad-usage rather than QOL; 3) no studies reporting continence outcomes defined by patient satisfaction metrics such as “bother;” 4) few studies using patient-reported, validated instruments collected by independent third parties; 5) the use of binary age thresholds (eg <70 versus ≥70 years) for analysis, with few studies utilizing age as a continuous variable; 6) few studies reporting the extremes of age for more individualized counseling of continence risk, ie for very young (<55 years) or very old (≥75 years); and 7) under-powered evaluations of older men aged ≥70 and, especially, ≥75 years.…”

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confidence: 99%

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How Does Age Affect Urinary Continence following Robot-Assisted Radical Prostatectomy? A Prospective Multi-Institutional Study Using Independently Collected, Validated Questionnaires

et al. 2022

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“…Furthermore, substantial evidence has emerged demonstrating the safety and feasibility of RP for appropriately selected older men with satisfactory oncological outcomes. 7,12–17…”

mentioning

confidence: 99%

mentioning

confidence: 99%

How Does Age Affect Urinary Continence following Robot-Assisted Radical Prostatectomy? A Prospective Multi-Institutional Study Using Independently Collected, Validated Questionnaires

et al. 2022

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“…Contrary to these papers with favourable outcomes, there have been studies that were not able to report reasonable continence rates. For instance, Gurung et al reported that the pad‐free continence rate was 43.9% in the >70 age group in their study 13 . In a previous study, Zorn et al evaluated the continence rates in men who had undergone RARP.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, Gurung et al reported that the pad-free continence rate was 43.9% in the >70 age group in their study. 13 In a previous study, Zorn et al evaluated the continence rates in men who had undergone RARP. The continence rate was 41% for the patients >60 years of age.…”

Section: Discussionmentioning

confidence: 99%

Perioperative adverse events and functional outcomes following open and robot‐assisted prostatectomy in patients over age 70

et al. 2021

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Aim To evaluate the safety (perioperative adverse events) of robot‐assisted radical prostatectomy (RARP) and functional outcomes (continence and erectile dysfunction) of open and robotic radical prostatectomy in elderly patients. Methods The data of patients (≥70 years old) who underwent open retropubic radical prostatectomy (ORRP) and RARP within the period from November 2014 to February 2019 were evaluated retrospectively. The perioperative adverse events and the functional outcomes of both surgical approaches were evaluated. Results A total of 149 men (59.3%) underwent ORRP, and 102 men (41.7%) underwent RARP. The mean age in the ORRP group was 73.6 ± 3.2 years, and that in the RARP group was 74.7 ± 4.1 years. The rate of grade 3 or higher (major) complications for the ORRP group was 4.7% (7 out of 149), and that for the RARP group was 4.9% (5 out of 102). The 24 months full continence and potency rates of the ORRP and RARP groups were 78.5% vs 79.4% and 21.8% vs 22.6%, respectively. Conclusion The perioperative adverse events are similar in elderly patients undergoing ORRP and in RARP. The continence rates are favourable and reasonable, although the potency rates are low in elderly men who underwent prostatectomy. The results of the present study may be useful for surgeons in their decision making and counselling of elderly patients.

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“…Additionally, total testosterone levels have been associated with positive MOR rates [ 35 , 36 ]. In contrast, age >70 years old has not been associated with probability of positive margins in a retrospective cohort of patients treated with robotic radical prostatectomy [ 37 ].…”

Section: Factors Affecting the Probability Of Margin Positivitymentioning

confidence: 99%

Radical or Not-So-Radical Prostatectomy: Do Surgical Margins Matter?

Grypari

Zolota

Tzelepi

2021

Cancers

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Prostate cancer is the second most common malignancy in men, and prostatectomy is the treatment of choice for most patients with at least low risk of progression. The presence of positive margins in the radical prostatectomy specimen is considered an adverse pathologic feature, and may prompt additional therapeutic intervention in the patients. The absence of a distinct capsule around the prostate and intraoperative manipulations that aim to minimize postoperative adverse effects, complicate its wide removal. Proper handling of the specimen during the gross processing is essential for accurate determination of the status of margins or resection. Positive margins, defined as the presence of neoplastic glands in the highlighted-with-ink margin of resection, range from 6–38%. The surgical technique, surgeon’s expertise and tumor (i.e., grade and stage) and patients’ (i.e., BMI) characteristics affect the rate of margin positivity. Extensive or multifocal and nonanterior/nonapical positive margins are linked with higher recurrence rates, especially in organ-confined disease, underscoring the need for treating these patients more aggressively. In summary, detailed description of the status of the margins should be performed in every pathology report to determine patients’ prognosis and the most appropriate therapeutic plan.

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Oncological and functional outcomes in patients over 70 years of age treated with robotic radical prostatectomy: a propensity-matched analysis

Cited by 19 publications

References 26 publications

How Does Age Affect Urinary Continence following Robot-Assisted Radical Prostatectomy? A Prospective Multi-Institutional Study Using Independently Collected, Validated Questionnaires

How Does Age Affect Urinary Continence following Robot-Assisted Radical Prostatectomy? A Prospective Multi-Institutional Study Using Independently Collected, Validated Questionnaires

Perioperative adverse events and functional outcomes following open and robot‐assisted prostatectomy in patients over age 70

Radical or Not-So-Radical Prostatectomy: Do Surgical Margins Matter?

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