Oncological and functional outcomes in patients over 70 years of age treated with robotic radical prostatectomy: a propensity-matched analysis

Purpose The aim of this study was to report on the safety (complications) and efficacy (oncological and functional outcomes) of robot-assisted radical prostatectomy (RARP), performed at our institution, in patients aged over 70. Patients and methods Review of our prospectively collected database [Ca...

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Bibliographic Details
Published in:World journal of urology 2021-04, Vol.39 (4), p.1131-1140
Main Authors: Gurung, Pratik M. S., Wang, Bokai, Hassig, Stephen, Wood, Jasmine, Ellis, Elizabeth, Feng, Changyong, Ghazi, Ahmed E., Joseph, Jean V.
Format: Article
Language:English
Subjects:
Age
Cancer
Cancer surgery
Catheterization
Erectile dysfunction
Medicine
Medicine & Public Health
Nephrology
Oncology
Original Article
Prostate cancer
Prostatectomy
Robotic surgery
Urological surgery
Urology
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Summary:Purpose The aim of this study was to report on the safety (complications) and efficacy (oncological and functional outcomes) of robot-assisted radical prostatectomy (RARP), performed at our institution, in patients aged over 70. Patients and methods Review of our prospectively collected database [Cancer Information Systems (CAISIS)] identified two hundred and fifteen (215) patients, aged > 70, who underwent RARP for localized prostate cancer between July 2003 and August 2017. A propensity score-matched analysis, with multiple covariates, was performed to stratify the patients into Age ≤ 70 and Age > 70 comparison groups. Results Apart from Age (mean ± SD years: 73.5 ± 2.1 vs 59.5 ± 5.9, p   0.05). Median follow-up was 10.6 years. There were no 90-day mortalities in either group. Minor complications (Clavien ≤ 2) were more common in the Age > 70 group ( p  = 0.0002). Operating room time ( p  = 0.83), length of hospital stay ( p  = 0.06) and catheterization duration ( p  = 0.13) were similar. On final pathology, a higher pT stage ( p   70 group. However, this did not translate adversely into higher rates of positive surgical margin ( p  = 0.41) or biochemical relapse ( p  = 0.72). Allowing for the follow-up duration (median 10.6 years), cancer-specific survival was marginally significant ( p  = 0.05) with an observed lower rate in the Age > 70 group. In terms of functional outcomes, post-operative erectile dysfunction and pad-free continence were significantly better in the younger cohort ( p  
ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-020-03304-x