Purpose: The current study aims to compare peri-operative and post-operative outcomes between robotic assisted vs. laparoscopic partial nephrectomy. Multiple reviews of the current literature have detailed the lack of single surgeon studies in this domain. To limit inter-operator bias, we utilise a single surgeon experienced in both approaches to reduce this bias seen in other multi-centre studies. Methods and Materials: We retrospectively compared patient demographics, tumour characteristics, peri-operative and post-operative outcomes of all partial nephrectomies undertaken by a single surgeon between 2014 and 2021 with experience in both laparoscopic and robotic surgery. The Da Vinci surgical system was utilized. Statistical analysis was carried out using GraphPad prism software version 7.03, San Diego, CA, USA. Results: Warm ischemia time was reduced by 2.6 min, length of stay reduced by 1.3 days and acute renal function deterioration was reduced by 55% with all these results being significant with robotic assisted partial nephrectomy compared to laparoscopic partial nephrectomy. Conclusion: This study highlights the benefits of robotic assisted in comparison to laparoscopic partial nephrectomy. Further large-scale prospective studies and cost-benefit analysis of robotic assisted partial nephrectomy would be valuable in confirming these findings and justifying the usage against their financial cost.

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Introduction: Salvage stereotactic body radiation therapy (SBRT) for localized prostate cancer recurrence following radiation therapy remains controversial. We performed a systematic review to assess the efficacy and side effect profile of salvage SBRT for locally recurrent prostate cancer to define the role of salvage SBRT in clinical practice.Methods: A systematic review was carried out using Pubmed (MEDLINE) and Scopus databases. Inclusion and exclusion criteria were satisfied if studies reported on patients with prior radiation therapy for prostate cancer who had subsequently had a local recurrence. Those studies included were quality assessed using the ROBINS-I checklist.Results: Five studies in total met criteria for inclusion and included all reportable outcomes. A total of 265 participants are reported on in total. Median doses for SBRT ranged from 30 to 36 Gy delivered over 5−6 fractions. Recurrence free survival ranged from 40% to 76% at 2 years. Genitourinary toxicity was more prevalent than gastrointestinal toxicities. Grade 2 and 3 genitourinary complication rates ranged from 5% to 22% and 0% to 9%, respectively. Gastrointestinal grade 2 complication rates ranged from 0% to 11% and no grade 3 complications were recorded.Discussion: Salvage SBRT appears to be comparable and potentially superior in some aspects to other salvage therapies, taking into account the limitations in cross-study comparisons. This systematic review serves as one of the first to characterize SBRT as a salvage option for locally recurrent prostate cancer.

Salvage stereotactic body radiation therapy (SBRT) for local prostate cancer recurrence following radiation therapy remains controversial. Salvage SBRT may cure disease recurrence however receives criticism as it carries with it risks of severe genitourinary and gastrointestinal toxicity. We performed a systematic review to assess the efficacy and side effects profile of salvage SBRT for locally recurrent prostate cancer to assess the role of salvage SBRT in clinical practice. A systematic review was carried out using Pubmed (MEDLINE) and Scopus databases. Inclusion and exclusion criteria were satisfied, and those studies included were quality assessed using the ROBINS-I checklist. Five studies in total met criteria for inclusion. Median doses for SBRT ranged from 30Gy to 36Gy delivered over 5 to 6 fractions. Recurrence free survival ranged from 40% to 76% at 2 years. Genitourinary toxicity was more prevalent than gastrointestinal toxicities. Grade 2 and 3 genitourinary complication rates ranged from 5 – 22% and 0 to 9% respectively. Gastrointestinal grade 2 complication rates ranged from 0 to 11% and no grade 3 complications were recorded. Lower dose SBRT generally was associated with less gastrointestinal and genitourinary side effects however had inferior recurrence free survival rates. This systematic review serves as one of the first to characterise SBRT as a salvage option for locally recurrent prostate cancer. Further large-scale prospective studies are required to guide whether the benefits outweigh the risk profile.