Robotic-Assisted Laparoscopic Prostatectomy for High-Risk Prostate Cancer: Technical Considerations and Review of the Literature

Stroup, Sean P.; Kane, Christopher J.

doi:10.5402/2011/201408

Cited by 4 publications

(9 citation statements)

References 42 publications

(33 reference statements)

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“…In addition, bulky disease and involvement of SVs and bladder neck by PCa could make dissection during RARP more difficult. 21 …”

Section: Important Surgical Technical Features In High-risk Patients mentioning

confidence: 99%

“…It has been suggested that HRPC may be associated with firm SVs that might suggest tumor invasion and necessitates careful manipulation of the tissues in order to completely remove with negative SMs ((−) SMs). 21 Following opening the Denonvillier's fascia, meticulous dissection should be done between the plane of rectum and prostate. In advanced cases, characterization of this plane might be difficult due to the presence of extra-capsular disease and in patients with previous androgen deprivation therapy.…”

Section: Important Surgical Technical Features In High-risk Patients mentioning

confidence: 99%

“…In advanced cases, characterization of this plane might be difficult due to the presence of extra-capsular disease and in patients with previous androgen deprivation therapy. 21 It is important to keep in mind that wide dissection and resection might lead to rectal injury particularly in patients with extra-capsular disease. On the other hand, dissecting as close as up to the apex between the plane of prostate and rectum following opening the Denonvillier's fascia significantly facilitates the procedure.…”

Section: Important Surgical Technical Features In High-risk Patients mentioning

confidence: 99%

“…Stroup and Kane suggested meticulous circumferential dissection of the prostate apex in order to avoid (+) SMs. 21 …”

Section: Important Surgical Technical Features In High-risk Patients mentioning

confidence: 99%

“…Likewise, other authors suggested considering extrafascial or modified nerve sparing approach with medial endopelvic fascia incision in an attempt to balance surgical oncologic control with functional outcomes. 21 …”

Section: Preservation Of Neurovascular Bundles In High-risk Patients mentioning

confidence: 99%

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Robotic radical prostatectomy in high-risk prostate cancer: current perspectives

Canda

Balbay

2015

Asian J Androl

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Around 20%–30% of patients diagnosed with prostate cancer (PCa) still have high-risk PCa disease (HRPC) that requires aggressive treatment. Treatment of HRPC is controversial, and multimodality therapy combining surgery, radiation therapy, and androgen deprivation therapy have been suggested. There has been a trend toward performing radical prostatectomy (RP) in HRPC and currently, robot-assisted laparoscopic RP (RARP) has become the most common approach. Number of publications related to robotic surgery in HRPC is limited in the literature. Tissue and Tumor characteristics might be different in HRPC patients compared to low-risk group and increased surgical experience for RARP is needed. Due to the current literature, RARP seems to have similar oncologic outcomes including surgical margin positivity, biochemical recurrence and recurrence-free survival rates, additional cancer therapy needs and lymph node (LN) yields with similar complication rates compared to open surgery in HRPC. In addition, decreased blood loss, lower rates of blood transfusion and shorter duration of hospital stay seem to be the advantages of robotic surgery in this particular patient group. RARP in HRPC patients seems to be safe and technically feasible with good intermediate-term oncologic results, acceptable morbidities, excellent short-term surgical and pathological outcomes and satisfactory functional results.

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“…In addition, bulky disease and involvement of SVs and bladder neck by PCa could make dissection during RARP more difficult. 21 …”

Section: Important Surgical Technical Features In High-risk Patients mentioning

confidence: 99%

Section: Important Surgical Technical Features In High-risk Patients mentioning

confidence: 99%

Section: Important Surgical Technical Features In High-risk Patients mentioning

confidence: 99%

“…Stroup and Kane suggested meticulous circumferential dissection of the prostate apex in order to avoid (+) SMs. 21 …”

Section: Important Surgical Technical Features In High-risk Patients mentioning

confidence: 99%

Section: Preservation Of Neurovascular Bundles In High-risk Patients mentioning

confidence: 99%

See 3 more Smart Citations

Robotic radical prostatectomy in high-risk prostate cancer: current perspectives

Canda

Balbay

2015

Asian J Androl

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Intraoperative Evaluation and Management of High-Risk Prostate Cancer during Robot-Assisted Radical Prostatectomy

Ürkmez

Davis

2022

Robotic Urologic Surgery

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Impact of laparoscopic radical prostatectomy on clinical T3 prostate cancer: experience of a single centre with long‐term follow‐up

et al. 2015

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ObjectiveTo investigate the oncological safety and effectiveness of laparoscopic radical prostatectomy (LRP) for patients with clinical T3 (cT3) prostate cancer compared with patients with cT1 and cT2 prostate cancer. Patients and MethodsIn all, 2375 consecutive LRPs were evaluated between 1999 and 2013. Of the 1751 patients enrolled with complete follow-up data (>24 months), patients were divided into three groups according to clinical stage of prostate cancer using Tumour-Node-Metastasis (TNM) classification. Group 1 consisted of patients with cT1 stage prostate cancer, group 2 those with cT2, and group 3 those with cT3. Demographic, postoperative, and long-term data of patients were recorded and statistical analyses were performed. ResultsThe mean (SD) age was 63.6 (6.2) years. The mean (SD) follow-up was 104 (28.4) months. There were 417 patients in group 1, 842 patients in group 2, and 492 patients in group 3. The mean prostate-specific antigen level, biopsy Gleason score, tumour volume, body mass index, and age, were all higher in group 3 (P < 0.001). Nerve-sparing techniques were used more in group 1 than in the other groups (P < 0.001). Extracapsular extension, seminal vesicle invasion, Gleason score, positive surgical margin (PSM), and rate of adjuvant hormone and radiotherapies were highest in group 3. However, urinary continence was similar in all groups. Group 1 contained the most patients with an erection sufficient for intercourse. Group 1 had the best cancer-specific survival rate, whereas overall survival (OS) rates and complications were similar in all groups. ConclusionLRP seems effective and safe for patients with cT3 prostate cancer with similar OS rates as for those with cT1 and cT2; however, additional therapies may have contributed to these rates. LRP can be considered for the treatment of patients with cT3 prostate cancer.

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Robotic-Assisted Laparoscopic Prostatectomy for High-Risk Prostate Cancer: Technical Considerations and Review of the Literature

Cited by 4 publications

References 42 publications

Robotic radical prostatectomy in high-risk prostate cancer: current perspectives

Robotic radical prostatectomy in high-risk prostate cancer: current perspectives

Intraoperative Evaluation and Management of High-Risk Prostate Cancer during Robot-Assisted Radical Prostatectomy

Impact of laparoscopic radical prostatectomy on clinical T3 prostate cancer: experience of a single centre with long‐term follow‐up

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