Comparative Outcomes of Salvage Retzius-Sparing versus Standard Robotic Prostatectomy: An International, Multi-Surgeon Series. Issue 5 (28th November 2021)
- Record Type:
- Journal Article
- Title:
- Comparative Outcomes of Salvage Retzius-Sparing versus Standard Robotic Prostatectomy: An International, Multi-Surgeon Series. Issue 5 (28th November 2021)
- Main Title:
- Comparative Outcomes of Salvage Retzius-Sparing versus Standard Robotic Prostatectomy: An International, Multi-Surgeon Series
- Authors:
- Kowalczyk, Keith J.
Madi, Rabii H.
Eden, Christopher G.
Sooriakumaran, Prasanna
Fransis, Karen
Raskin, Yannic
Joniau, Steven
Johnson, Scott
Jacobsohn, Kenneth
Galfano, Antonio
Bocciardi, Aldo M.
Hwang, Jonathan
Kim, Isaac Y.
Hu, Jim C. - Abstract:
- Abstract : Purpose: Salvage radical prostatectomy is rare due to the risk of postoperative complications. We compare salvage Retzius-sparing robotic assisted radical prostatectomy (SRS-RARP) with salvage standard robotic assisted radical prostatectomy (SS-RARP). Materials and Methods: A total of 72 patients across 9 centers were identified (40 SRS-RARP vs 32 SS-RARP). Demographics, perioperative data, and pathological and functional outcomes were compared using Student's t-test and ANOVA. Cox proportional hazard models and Kaplan-Meier curves were constructed to assess risk of incontinence and time to continence. Linear regression models were constructed to investigate postoperative pad use and console time. Results: Median followup was 23 vs 36 months for SRS-RARP vs SS-RARP. Console time and estimated blood loss favored SRS-RARP. There were no differences in complication rates or oncologic outcomes. SRS-RARP had improved continence (78.4% vs 43.8%, p <0.001 for 0–1 pad, 54.1% vs 6.3%, p <0.001 for 0 pad), lower pads per day (0.57 vs 2.03, p <0.001), and earlier return to continence (median 47 vs 180 days, p=0.008). SRS-RARP was associated with decreased incontinence defined as >0–1 pad (HR 0.28, 95% CI 0.10–0.79, p=0.016), although not when defined as >0 pad (HR 0.56, 95% CI 0.31–1.01, p=0.053). On adjusted analysis SRS-RARP was associated with decreased pads per day. Lymph node dissection and primary treatment with stereotactic body radiation therapy were associated withAbstract : Purpose: Salvage radical prostatectomy is rare due to the risk of postoperative complications. We compare salvage Retzius-sparing robotic assisted radical prostatectomy (SRS-RARP) with salvage standard robotic assisted radical prostatectomy (SS-RARP). Materials and Methods: A total of 72 patients across 9 centers were identified (40 SRS-RARP vs 32 SS-RARP). Demographics, perioperative data, and pathological and functional outcomes were compared using Student's t-test and ANOVA. Cox proportional hazard models and Kaplan-Meier curves were constructed to assess risk of incontinence and time to continence. Linear regression models were constructed to investigate postoperative pad use and console time. Results: Median followup was 23 vs 36 months for SRS-RARP vs SS-RARP. Console time and estimated blood loss favored SRS-RARP. There were no differences in complication rates or oncologic outcomes. SRS-RARP had improved continence (78.4% vs 43.8%, p <0.001 for 0–1 pad, 54.1% vs 6.3%, p <0.001 for 0 pad), lower pads per day (0.57 vs 2.03, p <0.001), and earlier return to continence (median 47 vs 180 days, p=0.008). SRS-RARP was associated with decreased incontinence defined as >0–1 pad (HR 0.28, 95% CI 0.10–0.79, p=0.016), although not when defined as >0 pad (HR 0.56, 95% CI 0.31–1.01, p=0.053). On adjusted analysis SRS-RARP was associated with decreased pads per day. Lymph node dissection and primary treatment with stereotactic body radiation therapy were associated with longer console time. Conclusions: SRS-RARP is a feasible salvage option with significantly improved urinary function outcomes. This may warrant increased utilization of SRS-RARP to manage men who fail nonsurgical primary treatment for prostate cancer. … (more)
- Is Part Of:
- Journal of urology. Volume 206:Issue 5(2021)
- Journal:
- Journal of urology
- Issue:
- Volume 206:Issue 5(2021)
- Issue Display:
- Volume 206, Issue 5 (2021)
- Year:
- 2021
- Volume:
- 206
- Issue:
- 5
- Issue Sort Value:
- 2021-0206-0005-0000
- Page Start:
- 1184
- Page End:
- 1191
- Publication Date:
- 2021-11-28
- Subjects:
- prostatic neoplasms -- prostatectomy -- neoplasm recurrence, local
Genitourinary organs -- Periodicals
Urology -- Periodicals
Urology -- Periodicals
Urologie -- Périodiques
Urologie
616.6 - Journal URLs:
- http://catalog.hathitrust.org/api/volumes/oclc/1754854.html ↗
http://www.jurology.com ↗
http://www.sciencedirect.com/science/journal/00225347 ↗
http://journals.lww.com/pages/default.aspx ↗ - DOI:
- 10.1097/JU.0000000000001939 ↗
- Languages:
- English
- ISSNs:
- 0022-5347
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 5071.900000
British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 21361.xml