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Trends in risk-group distribution and Pentafecta outcomes in patients treated with nerve-sparing, robot-assisted radical prostatectomy: a 10-year low-intermediate volume single-center experience
- Source :
- World Journal of Urology. 39:389-397
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- To evaluate the trends in risk-group distribution and Pentafecta outcomes in patients treated with nerve-sparing (NS), robot-assisted radical prostatectomy (RARP) in a single low-intermediate volume prostate cancer (PCa) center over a 10-year period. We queried a prospectively maintained database for patients who underwent NS RARP between 2009 and 2018 in a low-intermediate volume PCa center. Risk-groups were defined according to the D’Amico classification. Pentafecta outcomes referred to the postsurgical presence of potency and continence, and the absence of biochemical recurrence (BCR), positive surgical margins (PSM), and perioperative complications. The Kruskall–Wallis test, the t test and the Mann–Whitney tests were used when appropriate. 603 patients underwent NS RARP and 484 patients were evaluated for Pentafecta outcomes. Median postsurgical follow-up was 28 months. Overall, 137 (22.7%), 376 (62.3%), and 90 (15%) patients were diagnosed in the low-, intermediate-, and high-risk groups, respectively. Patients undergoing NS RARP shifted from 33 to 20% in the low-risk group, from 52 to 62% in the intermediate-risk group, and from 10 to 13% in the high-risk group. Patients reaching Pentafecta increased from 38 to 44%. No postoperative potency was the main reason for non-achieving Pentafecta (71%). BCR strongly limited Pentafecta achievement in the high-risk group (61%), but not in intermediate (24%) and low-risk (30%) groups. Low-intermediate volume PCa centers show similar trends to high-volume centers regarding risk group distributions over time in PCa patients undergoing NS RARP. We reported an increase in Pentafecta outcomes achievement over time even for experienced surgeons. Pentafecta outcomes achievement is risk-group dependent.
- Subjects :
- Male
Nephrology
Biochemical recurrence
medicine.medical_specialty
Hospitals, Low-Volume
Time Factors
Urology
medicine.medical_treatment
030232 urology & nephrology
Single Center
Risk Assessment
03 medical and health sciences
Prostate cancer
0302 clinical medicine
Risk groups
Robotic Surgical Procedures
Internal medicine
medicine
Humans
Distribution (pharmacology)
Aged
Retrospective Studies
Prostatectomy
business.industry
Prostate
Margins of Excision
Prostatic Neoplasms
Perioperative
Middle Aged
medicine.disease
Treatment Outcome
030220 oncology & carcinogenesis
business
Organ Sparing Treatments
Subjects
Details
- ISSN :
- 14338726 and 07244983
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- World Journal of Urology
- Accession number :
- edsair.doi.dedup.....7fc0e12aa5abf2940738c3a423c2f7c1