RADICAL RETROPUBIC AND ROBOT-ASSISTED PROSTATECTOMY IN PATIENTS WITH LOCALIZED PROSTATE CANCER: A COMPARATIVE ANALYSIS OF ONCOLOGICAL AND FUNCTIONAL OUTCOMES


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Abstract

Study included 583 patients with localized prostate cancer (PCa) has performed a comparative analysis of the effectiveness of robot- assisted (RA), radical prostatectomy (RPE) and radical retropubic prostatectomy (RRPPE) in terms of achievement of optimal oncological and functional outcomes. The first group consisted of 512 patients who underwent RARPE. The second group consisted of 71 patients who underwent RRPPE. In the RARPE group, median follow-up was 38.9 months (max 63.9), in the RRPPE group - 22.6 months (max 46). The groups were comparable in age, comorbidity, and cancer characteristics. It is emphasized that radical prostatectomy is the gold standard surgical treatment for localized prostate cancer. According to the analysis of the current literature and our own data it should be stated that, regardless of technology - retropubic or RA - RPE provides high performance and satisfactory results in disease-free and cancer-specific survival. On the other hand, the use of RARPE was much more effective in terms of the probability of postoperative continence and erectile function recovery within 12 months after surgery. There were significant differences not only in the overall proportion of patients who achieved a good functional outcome, but in the rate of function recovery.

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About the authors

P. L Rasner

SBEIHPE MSMSU n.a. A.I. Evdokimov of RMPH

Department of Urology

K. B Kolonarev

SBEIHPE MSMSU n.a. A.I. Evdokimov of RMPH

Email: kb80@yandex.ru
Teaching Assistant at the Department of Urology, Faculty of Postgraduate Education

A. V Govorov

SBEIHPE MSMSU n.a. A.I. Evdokimov of RMPH

Department of Urology

D. V Kotenko

SBEIHPE MSMSU n.a. A.I. Evdokimov of RMPH

Department of Urology

D. Yu Pushkar

SBEIHPE MSMSU n.a. A.I. Evdokimov of RMPH

Department of Urology

References

  1. Wilson Т., Torrey Я. Open versus robotic-assist- ed radical prostatectomy: which is better? Curr. Opin. Urol. 2011;21(3):200-5.
  2. Boorjian S.A., Eastham J.A., Graefen M., Guilhnneau B., Karnes RJ., Moul J.W., Schaeffer E.M., Stief C, Zorn КС. A critical analysis of the long-term impact of radical prostatectomy on cancer control and function outcomes. Eur. Urol. 2012;61:664-75.
  3. Mottrie A., De Naeyer G., Novara G., Ғісагга V. Robotic radical prostatectomy: a critical analysis of the impact on cancer control. Curr. Opin. Urol. 2011;21:179-84.
  4. Pfitzenmaier J., Pahernik S., Tremmel T., Haferkamp A., Buse S., Hohenfellner M. Positive surgical margins after radical prostatectomy: do they have an impact on biochemical or dinical progression? BJU Int. 2008;102:1413-18.
  5. Menon M., Bhandari M., Gupta N., Lane Z, Peabody J.O., Rogers C.G., Sammon J., Siddiqui S.A., Diaz M. Biochemical recurrence following robot-assisted radical prostatectomy.analysis 1384 patients with a median 5-year follow-up. Eur. Urol. 2010;58:838-46.
  6. Xylinas E., Durand X., Ploussard G., Campeggi A., Allory Y., Vordos D., Hoznek A., Abbou C.C., de la Taille A., Salomon L. Evaluation of combined oncologic and functional outcomes after robot- ic-assisted laparoscopic extraperitoneal radical prostatectomy: trifecta rate of achieving continence, potency and cancer control. Urol Oncol. 2013:31 (1 ):99-103.
  7. Suardi N., Ficarra V., Willemsen P., De Wil P., Gallina A.,De Naeyer G.,Schatteman P., Montorsi F., Carpentier P., Mottrie A. Long-term biochemical recurrence rates after robot-assisted radical prostatectomy: anal-ysis of a single-center series of patients with a minimum follow-up of 5 years. Urology. 2012;79:133-38.
  8. Zorn K.C., Wille M.A., Thong A.E., Katz M.H., Shikanov S.A., Razmaria A., Gofrit O.N., Zaga- ja G.P., Shalhav A.L. Continued improvement of perioperative, pathological and continence outcomes during 700 robot-assisted radical prostatectomies. Can.J. Urol. 2009;16:4742-49.
  9. Samadi D.B., Muntner P., Nabizada-Pace F., Brajtbord J.S., Carlucci J., Lavery H.J. Improvements in robot-assisted prostatectomy: the effect of surgeon experience and technical changes on oncologic and functional outcomes. J. Endourol. 2010;24:1105-10.
  10. Tewari A., Srivasatava A., Menon M. A prospective comparison of radical retropubic and robot-assisted prostatectomy: experience in one institution. BJU Int. 2003;92:205-10.
  11. Smith Jr J.A., Chan R.C., Chang S.S., Herrell S.D., Clark P.E., Baumgartner R., Cookson M.S. A comparison of the incidence and location of positive surgical margins in robotic assisted laparoscopic radical prostatectomy and open retropubic radical prostatectomy. J. Urol. 2007;178:2385-9. Discuss. 2389-90.
  12. Yossepowitch 0., Briganti A., Eastham J.A., Epstein J., Graefen M., Montironi R., Touijer K. Positive Surgical Margins After Radical Prostatectomy: A Systematic Review and Contemporary Update. Eur. Urol. 2014;65:303-13.
  13. Ficarra V., Novara G., Secco S., D'Elia C, Boscolo- Berto ft., Gardiman M., Cavalleri S., Artibani W. Predictors of positive surgical margins after laparoscopic robot assisted radical prostatectomy. J. Urol. 2009;182:2682-88.
  14. Patel V.R., Coelho R.F., Rocco B., Orvieto M., Sivaraman A., Palmer K.J., Kameh D., Santoro L, Coughlin G.D., Liss M., Jeong W., Malcolm J., Stern J.M., Sharma S., Zorn КС., Shikanov S., Shalhav A.L., Zagaja G.P., Ahlering T.E., Rha K.H., Albala D.M., Fabrizio M.D., Lee D.I., Chauhan S. Positive surgical margins after robotic assisted radical prostatectomy: a multi-institutional study. J. Urol. 2011;186:511-16.
  15. Lo K.L., Ng C.F., Lam C.N., Hou S.S., To K.F., Yip S.K. Short-term outcome of patients with robot- assisted versus open radical prostatectomy: for local- ised carcinoma of prostate. Hong Kong Med J. 2010;16:31-5.
  16. Krambeck A.E., DiMarco D.S., Rangel L.J., BergstralhEJ., Myers R.P., BluteM.L., GettmanM. T. Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retropubic and robot-assisted techniques. BJU Int. 2009;103:448-53.
  17. Ficarra V., Novara G., Artibani W., Cestari A., GalfanoA., Graefen M., GuazzoniG., Guillonneau B., Menon M., Montorsi F., Patel V., RassweilerJ., Van Poppel H. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies. Eur. Urol. 2009;55:1037-63.
  18. Hu J.C., Gu X.,Lipsitz S.R.,Barry M.J., D'Amico A.V., Weinberg A.C., Keating N.L. Comparative effectiveness of minimally invasive vs open radical prostatectomy. JAMA. 2009;302:1557-64.
  19. Rocco B., Matei D.V., Melegari S., Ospina J.C., Mazzoleni F., Errico G., Mastropasqua M., Santoro L, Detti S., de Cobelli 0. Robotic vs open prostatectomy in a laparoscopically naive centre: a matched-pair analysis. BJU Int. 2009;104:991-95.
  20. DiPierro G.B., Baumeister P., Stucki P., Beatrice I., Danuser H., Mattei A. A prospective trial comparing consecutive series of open retropubic and robot- assisted laparoscopic radical prostatectomy in a centre with a limited caseload. Eur. Urol. 2011;59(1):1-6.
  21. Thorsteinsdottir T., Stranne J., Carlsson S., Anderberg B., Bjorholt I., Damber J.E., Hugosson J., Wilderang U., Wiklund ft., Steineck G., Haglind E. LAPPRO: a prospective multicentre comparative study of robot-assisted laparoscopic and retropubic radical prostatectomy for prostate cancer. Scand.J. Urol. Nephrol. 2011 ;45(2):102-12.
  22. Dubbelman Y.D., Dohle G.R., Schroder F.H. Sexual function before and after radical retropubic prostatectomy: a systematic review of prognostic indicators for a successful outcome. Eur. Urol. 2006;50:711-20.

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