Perioperative Red Cell Line Trend following Robot-Assisted Radical Prostatectomy for Prostate Cancer

Abstract

Background and Objective: Blood loss represents a long-standing concern of radical prostatectomy (RP). This study aimed to assess how red line cell values changed following robot-assisted radical prostatectomy (RARP) for prostate cancer (PCa). Materials and Methods: The blood panels of 453 consecutive PCa patients undergoing RARP at a single tertiary academic referral center, from September 2020 to April 2022, were reviewed. Data from 363 patients with the blood panel available for the following timeframe: within seven days before surgery, six hours after surgery, and the first three postoperative days, were analyzed. Specifically, hemoglobin (Hb, g/dL), red blood cells (RBCs, ×106/μL), and hematocrit (HCT, %) trends were collected. Results: Considering the Hb trend, the median values in the preoperative day, postoperative day (POD) 2, and POD 3 are 14.7 (interquartile range [IQR] = 13.9–15.4), 12.1 (IQR = 11.2–12.9), and 12.2 (IQR = 11.2–13.1), respectively. The ∆ between preoperative day and POD 2 is 2.5 (IQR = 1.8–3.2) (p < 0.001). Considering the RBCs trend, the median values in the preoperative day, POD 2, and POD 3 are 4.9 (IQR = 4.7–5.3), 4.1 (IQR = 3.8–4.4), and 4.1 (IQR = 3.8–4.5), respectively. The ∆ between preoperative day and POD 2 is 0.9 (IQR = 0.6–1.1) (p < 0.001). Considering the HCT trend, the median values in the preoperative day, POD 2, and POD 3 are 44.4 (IQR = 41.7–46.6), 36.4 (IQR = 33.8–38.9), and 36.1 (IQR = 33.5–38.7), respectively. The ∆ between preoperative day and POD 2 is 7.8 (IQR = 5.2–10.5) (p < 0.001). Conclusions: Overall, patients undergoing RARP experience a significant, but clinically limited, decline in red line cell values between the preoperative time and the second day post-surgery. These observations are important to provide physicians with knowledge of the expected postoperative course and, thus, to improve the quality of patient care.

Comparative Outcomes of Robotic Radical Prostatectomy in Patients with Locally Advanced Prostate Cancer

“…Blood loss is an important concern during RARP. Di Bello et al studied red blood cell count, hemoglobin (Hb), and hematocrit in 363 patients with prostate cancer who underwent RAR [35]. In the peri-operative period, there was a short-term significant decline in Hb of approximately 3 points between the pre-operative period and 2 days after surgery.…”

Incidence and Predicting Factors of Histopathological Features at Robot-Assisted Radical Prostatectomy in the mpMRI Era: Results of a Single Tertiary Referral Center

“…The highest risk of PCa is in men over 50 years of age or age > 45 years with a family history of PCa [ 3 , 4 , 5 , 6 ]. The diagnosis is made by prostate biopsy in patients with abnormalities detected in their prostate-specific antigen (PSA) levels or digital rectal exam (DRE) [ 7 , 8 , 9 ]. In the last decade, there has been growth in the use of multiparametric magnetic resonance imaging (mpMRI) for the diagnosis and characterization of PCa based on the Prostate Imaging Reporting And Data System (PI-RADS v.2) [ 10 , 11 ].…”

“…According to the European Association of Urology (EAU) guidelines, histological grading of adenocarcinoma of the prostate is based on the definition of the International Society of Urological Pathology (ISUP) or Gleason grade group (GGG) modified grading, defined as ISUP 1 (Gleason score [GS] 6 [3 + 3]), ISUP 2 (GS 7 [3 + 4]), ISUP 3 (GS 7 [4 + 3]), ISUP 4 (GS 8 [4 + 4]) and ISUP 5 (GS 9 or 10) [ 2 , 8 , 9 ]. The GGG is the most important prognostic indicator for PCa [ 12 , 13 , 14 , 15 ].…”