Comparing open and robotic salvage radical prostatectomy after radiotherapy: predictors and outcomes
| Autor: | Wenceslao Villamil, Agustin Romeo, Carlos Roberto Giúdice, Ignacio Tobia, Pablo Martínez, Mariana Isola |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Blood transfusion Urology medicine.medical_treatment Brachytherapy 030232 urology & nephrology Urinary incontinence Anastomosis lcsh:RC870-923 03 medical and health sciences 0302 clinical medicine Salvage radical prostatectomy medicine External beam radiotherapy Survival rate Prostate cancer Radiotherapy business.industry Prostatectomy Robotic surgery lcsh:Diseases of the genitourinary system. Urology Confidence interval Surgery 030220 oncology & carcinogenesis medicine.symptom business Research Article |
| Zdroj: | Prostate International Prostate International, Vol 9, Iss 1, Pp 42-47 (2021) |
| ISSN: | 2287-8882 |
| Popis: | Introduction In the present study, we aim to provide more evidence about benefits of salvage radical prostatectomy (SRP). Our main objective is to assess prostatic-specific antigen control and postoperative urinary incontinence in open and robotic approaches as primary outcomes. Materials and methods After the Institutional Review Board approval (IRB00010193), we retrospectively analyzed 76 consecutive patients who underwent open or robot-assisted SRP for locally relapsed prostate cancer between 2004 and 2019 at the Urology Department of Hospital Italiano de Buenos Aires, Argentina. Data were collected from our electronic medical record and prospective database. Postoperative variables, such as urinary incontinence, erectile function preservation, and vesicourethral anastomosis stricture development, were analyzed. Results Before SRP, 59 patients (76.6%) were treated with 3D external beam radiotherapy, 11 (14.3%) with brachytherapy, and 6 (7.8%) with intensity-modulated radiotherapy. Fifty patients underwent open SRP, and 26, robot-assisted SRP. Comparing surgical approaches, the global incontinence rate was 34.2% versus 9.1% in open versus robot-assisted approach, respectively (p: 0.01). Vesicourethral anastomosis stricture occurred in six patients (8.7%), all in the open approach group (p: 0.07). Five patients of 69 (7.2%) preserved erectile function with/without use of phosphodiesterase 5 inhibitors. Two patients in the open approach group needed blood transfusion. Estimated 2-year biochemical recurrence–free survival rate in the open approach group and robot-assisted group was 67% (95% confidence interval: 53.7–80.3) and 60.9% (95% confidence interval: 40.5–81.3), respectively, with no statistical difference (log-rank test p: 0.873). Conclusions Robot-assisted SRP is a reliable procedure to treat local recurrences after external beam radiotherapy or brachytherapy, reducing the risk of anastomotic strictures and blood loss and improving continence outcomes. |
| Databáze: | OpenAIRE |
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