Pd19-10 patient and Disease Specific Risk Factors and Nerve Sparing Have a Significant Impact on Long Term Sexual Functional Following Minimally Invasive Radical Prostatectomy

Abstract

cytoreductive prostatectomy; C e conventional treatment (ADT, chemotherapy), or local radiotherapy; O e oncological outcomes (CSS, progression-free survival (PFS), overall survival (OS)), functional outcomes (urinary incontinence and erectile function (EF) rates), complications. The primary outcomes were the oncological results: cancer-specific survival (CSS), progression-free survival (PFS), overall survival (OS). The secondary outcomes were complication rates and functional results (urinary continence).RESULTS: In all the studies OS was better or at least comparable in the groups with CRP and no local treatment (NLT). The most essential benefit from CRP was noted by Culp et al. (5-year OS 67.4% for RP vs 22.5 for NLT). CSS showed the same trend. Positive surgical margin rate ranged from 28.6% up to 100%. Urinary continence in CRP was significantly lower, than in RP for localized PCa, 57.4% vs 90.8%, p<0.0001. But severe incontinence occurred seldom (2.5e18.6%). Between 50% and 84.6% of the patients were completely continent. Total complications rate after CRP differed widely, from 7e8.8% to 41.2e43.6%. Rates of grade 1 and 2 events prevailed. The patients on ADT alone also showed a considerable number of complications, varying from 5.9% to 57.7%. A significant proportion (26.8%-44.7%) of them required interventions due to local progression.CONCLUSIONS: CRP improves medium-term cancer control in patients with oligometastatic PCa. This surgery results in what we believe to be an acceptable complication rate with a slightly impaired urinary continence as compared to RP for a localized disease.