Robot‐assisted radical prostatectomy in men aged ≥70 years

Abstract

age ( ≥ 70 vs < 70 years). All data were recorded prospectively in an institutional approved database. RESULTSOf the 203 men, 23 (11%) were aged ≥ 70 years; the older men had similar baseline characteristics as younger men, and had characteristics during and after surgery comparable to those in younger men. The pathological RARP Gleason grade was significantly greater in older men. Surgical complications were not significantly different between the groups. Continence rates were significantly lower in older men at 6 months after surgery, but returned to levels equivalent to those in younger men within 12 months after surgery. Older patients took significantly longer to be capable of driving after surgery. CONCLUSIONSThe outcomes of RARP in elderly men are largely comparable to those in younger men, with the exception of higher pathological Gleason grade, a transient delay in return of continence, and taking longer to return to driving after surgery. Advanced chronological age should not be a contraindication for RARP in patients with clinically localized prostate cancer, but expectations should be managed preoperatively.

Older age does not impact perioperative complications after robot-assisted radical prostatectomy

“…Our findings confirm the findings of other studies of older patients undergoing minimally invasive radical prostatectomy. In a recently published study of a smaller group of older men undergoing RARP (n = 23), Greco et al found results similar to ours [25]. Poulakis et al found no increased perioperative complications amongst older men undergoing laparoscopic radical prostatectomy [26].…”

“…Data on sexual and urinary outcomes are still forthcoming from our institution. Another interesting aspect to consider is whether, like the laparoscopic approach [25], elderly patients do better with the robotic approach compared with open prostatectomy. Comparing outcomes prospectively between curative treatments such as radiation versus surgery in elderly patients should also be considered for future study.…”

Impact of Age on Quality-of-life Outcomes After Treatment for Localized Prostate Cancer

“…However, older men are more likely to be diagnosed with high-risk disease and these individuals face a higher risk of cancer-specific mortality in the absence of local therapy [13][14][15]. Despite this, older men have comparable outcomes and cancer control after treatment for localized disease [16,17]. Therefore, the potential impact of treatment on QOL must be measured against the individualized risk of progressive cancer.…”

Safety and feasibility of robot-assisted radical prostatectomy for clinically localized prostate cancer in elderly Japanese patients

“…Watchful waiting and active surveillance might aggravate the psychological stress associated with cancer diagnosis. Despite the optimal treatment for men ≥ 70 years diagnosed with PCa still being controversial, the demographic finding that most PCa deaths are observed in elderly men may suggest that some cases of PCa are not treated adequately in this population 3, 7, 8…”

“…Therefore, this paradigm shift in RP procedures might increase the suitability of elderly candidates for surgery. Despite the fact that the potential role for robot-assisted RP (RARP) in elderly patients needs to be further defined as the elderly population grows, there have been few reports of RARP in these patients,7, 8, 9, 10 and none in elderly Japanese men with PCa.…”