Robot-assisted radical prostatectomy in Hong Kong: a review of 235 cases.
| Autor: | Yip KH; Department of Surgery, Chinese University of Hong Kong, Hong Kong., Yee CH, Ng CF, Lam NY, Ho KL, Ma WK, Li CM, Hou SM, Tam PC, Yiu MK, Fan CW |
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| Jazyk: | angličtina |
| Zdroj: | Journal of endourology [J Endourol] 2012 Mar; Vol. 26 (3), pp. 258-63. Date of Electronic Publication: 2012 Jan 04. |
| DOI: | 10.1089/end.2011.0303 |
| Abstrakt: | Objectives: To report the outcome of all robot-assisted laparoscopic radical prostatectomy (RALP) in the public health care system in Hong Kong. Patients and Methods: All patients who underwent RALP in the public health care system with at least 1 year of follow-up were evaluated. Data analysis included age, body mass index, preoperative prostate-specific antigen (PSA) level, D'Amico risk category, operative details, pathologic stage, follow-up continence, potency, and biochemical recurrence. Results: Between 2005 and 2009, 235 patients underwent RALP, with a mean age of 66.4±5.9 years and a mean preoperative PSA level of 11.0±10.5 ng/mL. Complications were 16 (7%) in total. There were 176 (74.9%) patients with pT(2) disease and 55 (23.4%) patients with pT(3) disease. The overall rate of positive surgical margins (PSM) was 20.7%. At postoperative 12 months, 72.5% of the patients were pad free. For those 83 preoperative potent patients having nerve-sparing surgery, the overall trifecta rate at 12 months was 37.3%. Multivariate analysis identified that pathologic T staging was significantly associated with PSM, with an odds ratio (OR) of 7.884 (95% confidence interval [CI]: 3.576-17.379; P<0.001) for the pT(3) group compared with the pT(2) group. When comparing D'Amico medium- and high-risk categories with low-risk categories, they were found to be significantly associated with biochemical failure (medium- compared with low-risk: OR=3.536, 95% CI: 1.253-10.173, P=0.016; high- compared with low-risk: OR=10.214, 95% CI: 2.958-35.274, P<0.001). Conclusions: Our data demonstrate the feasibility, safety, and efficacy of RALP in low-to-intermediate volume centers. Our early oncologic outcomes were significantly correlated with pathologic stage and D'Amico risk stratification. |
| Databáze: | MEDLINE |
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