Survival After Robotic-assisted Prostatectomy for Localized Prostate Cancer

Wang, Yuefeng; Gieschen, Holger; Greenberger, Mark; Yu, Xinhua; MD, Gary G. Tian,; VanderWalde, Noam A.; Stockstill, Todd; Farmer, Michael; Rinker, Lillian H.; Izaguirre, Enrique; Somer, Bradley G.; Ballo, Matthew T.

doi:10.1097/sla.0000000000003637

Cited by 6 publications

(4 citation statements)

References 44 publications

(95 reference statements)

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“…The result was similar with a previous study reporting that the all-cause mortality was 3.9%. [36] However, the cancer-specific mortality was lower than previous reports (1.7% and 4.3%). [37,38] This might be due to the higher surgical volume at our center and higher level of experience because we excluded patients from the learning curve period of the first two years of surgery performed by our teams.…”

Section: Plos Onementioning

confidence: 56%

Propofol-based total intravenous anesthesia is associated with better survival than desflurane anesthesia in robot-assisted radical prostatectomy

et al. 2020

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Background Previous researches have shown that anesthetic techniques may influence the patients' outcomes after cancer surgery. Here, we studied the relationship between the type of anesthetic techniques and patients' outcomes following elective robot-assisted radical prostatectomy. Methods This was a retrospective cohort study of patients who received elective, robot-assisted radical prostatectomy between January 2008 and December 2018. Patients were grouped according to the anesthesia they received, namely desflurane or propofol. A Kaplan-Meier analysis was conducted, and survival curves were presented from the date of surgery to death. Univariable and multivariable Cox regression models were used to compare hazard ratios for death after propensity matching. Subgroup analyses were performed for tumornode-metastasis stage and disease progression. The primary outcome was overall survival, and the secondary outcome was postoperative biochemical recurrence. Results A total of 365 patients (24 deaths, 7.0%) under desflurane anesthesia, and 266 patients (2 deaths, 1.0%) under propofol anesthesia were included. The all-cause mortality rate was significantly lower in the propofol anesthesia than in the desflurane anesthesia during follow-up (P = 0.001). Two hundred sixty-four patients remained in each group after propensity matching. The propofol anesthesia was associated with improved overall survival (hazard ratio, 0.11; 95% confidence interval, 0.03-0.48; P = 0.003) in the matched analysis.

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Section: Plos Onementioning

confidence: 56%

Propofol-based total intravenous anesthesia is associated with better survival than desflurane anesthesia in robot-assisted radical prostatectomy

et al. 2020

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“…11,36,37 Though it is possible that for some patients RARP may afford better perioperative outcomes which may then be associated with improved overall survival compared to ORP, evidence generated by high-quality Randomized Clinical Trials (RCTs) with long-term follow-up is not available. 38 There is an abundance of evidence in the literature related to racial and ethnic disparities in prostate cancer diagnosis, treatment, and outcomes-especially for non-Hispanic Black patients. 39,40 Non-Hispanic Black patients have higher incidence of prostate cancer and are more likely to present with metastases than non-Hispanic White patients.…”

Section: Discussionmentioning

confidence: 99%

“…HVHs use RARP much more often than low‐volume hospitals (LVHs), making the use of RARP a possible surrogate for the volume‐outcome relationship which has been described extensively in the literature 11,36,37 . Though it is possible that for some patients RARP may afford better perioperative outcomes which may then be associated with improved overall survival compared to ORP, evidence generated by high‐quality Randomized Clinical Trials (RCTs) with long‐term follow‐up is not available 38 …”

Section: Discussionmentioning

confidence: 99%

Disparities in access to robotic technology and perioperative outcomes among patients treated with radical prostatectomy

Logan

Mahenthiran

Siddiqui

et al. 2023

Journal of Surgical Oncology

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Background Most radical prostatectomies are completed with robotic assistance. While studies have previously evaluated perioperative outcomes of robot‐assisted radical prostatectomy (RARP), this study investigates disparities in access and clinical outcomes of RARP. Study Design The National Cancer Database (NCDB) was used to identify patients who received radical prostatectomy for cancer between 2010 and 2017 with outcomes through 2018. RARP was compared to open radical prostatectomy (ORP). Odds of receiving RARP were evaluated while adjusting for covariates. Overall survival was evaluated using a propensity‐score matched cohort. Results Overall, 354 752 patients were included with 297 676 (83.9%) receiving RARP. Patients who were non‐Hispanic Black (82.8%) or Hispanic (81.3%) had lower rates of RARP than non‐Hispanic White (84.0%) or Asian patients (87.7%, p < 0.001). Medicaid or uninsured patients were less likely to receive RARP (75.5%) compared to patients with Medicare or private insurance (84.4%, p < 0.001). Medicaid or uninsured status was associated with decreased odds of RARP in adjusted multivariable analysis (OR 0.61, 95% CI 0.49–0.76). RARP was associated with decreased perioperative mortality and improved overall survival compared to ORP. Conclusion Patients who were underinsured were less likely to receive RARP. Improved access to RARP may lead to decreased disparities in perioperative outcomes for prostate cancer.

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“…From 2003 to 2007, the proportion of minimally invasive procedures (including LRP and RARP) for RP in the United States rose sharply from 4.9% to 44.5%, while RRP dropped from 89.4% to 52.9% ( 3 ). So far, many studies have suggested that RARP can achieve positive surgical margins (PSM) rate as low as LRP, and it has shown advantages over LRP in intraoperative blood loss (188.0 mL), intraoperative blood transfusion rate (1.8%), and average postoperative hospital stay (4 days) ( 4 , 5 ). While improving the incidence of perioperative complications, RARP reduces the proportion of long-term urinary incontinence to about 9%, which is better than open surgery [odds ratio (OR) =1.53] and LRP (OR =2.39) ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Transperineal single-port robot-assisted radical prostatectomy with Si da Vinci surgical system: initial experience and description of technique

Ni¹,

Xue²,

Li³

2021

Transl Cancer Res TCR

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Background: Single-port robotic-assisted radical laparoscopic prostatectomy has emerged as a novel robotic-assisted radical laparoscopic prostatectomy in recent years, arousing wide attention. However, singleport robotic-assisted radical laparoscopic prostatectomy using Si da Vinci surgical system has been rarely reported, especially via the transperineal approach.Methods: We retrospectively collected 9 cases of prostate cancer patients who underwent transperineal single-port robot-assisted radical prostatectomy (t-spPARP) using Si da Vinci surgical system in our center from May 2020 to June 2020. The operation time, estimated blood loss (EBL), complications, changes in prostate-specific antigen (PSA) 3 months after surgery, and urinary continence recovery 6 months after surgery were analyzed.Results: No perioperative complications were recorded. The median [interquartile range (IQR)] operation time was 350 [150] min and the median [IQR] EBL was 300 [100] mL. PSA levels were less than 0.01 ng/mL at 3 months postoperatively in all cases (undetectable in 8 cases). All the 9 patients recovered their urinary continence 6 months after surgery and merely two patients required pads during the day.Conclusions: t-spRARP was verified as a safe and feasible surgical alternative to treat patients with localized prostate cancer, especially for those whose prostate is small-volume or who had abdominal surgery history.

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Survival After Robotic-assisted Prostatectomy for Localized Prostate Cancer

Abstract: Supplemental Digital Content is available in the text

Cited by 6 publications

References 44 publications

Propofol-based total intravenous anesthesia is associated with better survival than desflurane anesthesia in robot-assisted radical prostatectomy

Propofol-based total intravenous anesthesia is associated with better survival than desflurane anesthesia in robot-assisted radical prostatectomy

Disparities in access to robotic technology and perioperative outcomes among patients treated with radical prostatectomy

Transperineal single-port robot-assisted radical prostatectomy with Si da Vinci surgical system: initial experience and description of technique

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