Nerve-sparing robotic prostatectomy in preoperatively high-risk patients is safe and efficacious

Lavery, Hugh J.; Nabizada‐Pace, Fatima; Carlucci, John R.; Brajtbord, Jonathan S.; Samadi, David B.

doi:10.1016/j.urolonc.2009.11.023

Cited by 57 publications

(47 citation statements)

References 26 publications

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“…Our results are close to those of Novara et al, who reported a trifecta rate of 57 % after robot-assisted RP, at 12 months [20]. However, looking only at high-risk PCa, Lavery et al [21] found a trifecta rate of 23 %. According to a recent review, trifecta rates after nsRP range from 20 to 76 % [2].…”

Section: Discussionsupporting

confidence: 89%

Extended versus limited pelvic lymph node dissection during bilateral nerve-sparing radical prostatectomy and its effect on continence and erectile function recovery: long-term results and trifecta rates of a comparative analysis

Hatzichristodoulou

Wagenpfeil

et al. 2015

World J Urol

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Section: Discussionsupporting

confidence: 89%

Extended versus limited pelvic lymph node dissection during bilateral nerve-sparing radical prostatectomy and its effect on continence and erectile function recovery: long-term results and trifecta rates of a comparative analysis

Hatzichristodoulou

Wagenpfeil

et al. 2015

World J Urol

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“…Men who underwent a nerve-sparing procedure had a significantly lower rate of positive surgical margins than those where nerve sparing was omitted (37% versus 54%, p ¼ 0.002), most likely due to a selection bias. Lavery and colleagues reported on 1503 high-risk PCa patients undergoing RP [Lavery et al 2010]. A nervesparing procedure was performed in 73% of cases.…”

Section: Introductionmentioning

confidence: 99%

Surgery for high-risk localized prostate cancer

Schmitges

Trinh

Walz

et al. 2011

Therapeutic Advances in Urology

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Treatment of men with high-risk prostate cancer (PCa) remains challenging for urologists. The complex natural history of high-risk PCa and the lack of specific and accurate definitions for high-risk disease impede treatment decision making. Historically, surgery in this patient group has been avoided based on the perception of ostensibly higher complication rates associated with inferior functional and oncological outcomes. To date, no randomized data comparing different therapy approaches have been made available. Several investigators have reported that continence rates in patients after radical prostatectomy (RP) for high-risk disease seem to be unaffected. Similarly, in a large proportion of these men, a nerve-sparing procedure can be performed without a significant negative impact on surgical margin rates and with comparable potency results. Moreover, extended pelvic lymph node dissection (EPLND) contributes to accurate pathological staging with a marginal effect on perioperative morbidity. With regards to the benefits of RP on local recurrence and cure rates, realistic expectations regarding the success of RP alone or in the context of a multimodal approach should be provided during patient counseling.

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“…Although some recent studies demonstrated that RALP was useful and feasible in locally advanced tumor, the outcomes of RALP after NHT have not been reported [1,2]. In general, NHT increased prostatic apoptosis and decreased proliferation of prostate cancer cells, which induce tumor regression.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 20% of men who underwent radical prostatectomy for clinical stage T3 prostate cancer had pathological organ-confined disease [9]. However, recently RALP has been performed in selected patients with locally advanced prostate cancer with an acceptable oncologic outcome [1,2].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, RALP, as a representative of urologic surgery, has become a common surgical treatment modality for localized prostate cancer, even on high-risk prostate cancer patients who have a long life expectancy [1,2]. However, patients with locally advanced prostate cancer need wide excision around the bladder neck to prevent a positive surgical margin.…”

Section: Introductionmentioning

confidence: 99%

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Immediate robot-assisted ureteral reimplantation during robotic prostatectomy in locally advanced prostate cancer

et al. 2011

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We report the technique and outcomes of immediate robot-assisted ureteral reimplantation due to unexpected ureteral injury during robot-assisted laparoscopic prostatectomy (RALP). A 61-year-old male was diagnosed with locally advanced prostate adenocarcinoma (T3bN0M0). Multiple positive margins at the bladder neck were noted on frozen section during RALP, and re-excision of the bladder neck was done. Unfortunately, the distal third of right ureter was transected. We immediately performed robot-assisted ureteroneocystostomy with double J stent insertion. No complications developed during the follow-up period.

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Nerve-sparing robotic prostatectomy in preoperatively high-risk patients is safe and efficacious

Cited by 57 publications

References 26 publications

Extended versus limited pelvic lymph node dissection during bilateral nerve-sparing radical prostatectomy and its effect on continence and erectile function recovery: long-term results and trifecta rates of a comparative analysis

Extended versus limited pelvic lymph node dissection during bilateral nerve-sparing radical prostatectomy and its effect on continence and erectile function recovery: long-term results and trifecta rates of a comparative analysis

Surgery for high-risk localized prostate cancer

Immediate robot-assisted ureteral reimplantation during robotic prostatectomy in locally advanced prostate cancer

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