Short‐term oncological and surgical outcomes of robot‐assisted radical prostatectomy: A retrospective multicenter cohort study in Japan (the MSUG94 group)

Abstract

Introduction: We evaluated oncological outcomes of patients undergoing robot-assisted radical prostatectomy (RARP) for prostate cancer (PCa) and their perioperative complications in Japan. We investigated clinical and pathological covariates to predict biochemical recurrence (BCR) after RARP.Methods: A retrospective multicenter cohort study was conducted in RARP patients with PCa at 10 institutions in Japan. Pre-and postoperative covariates were collected from enrolled patients. The primary endpoint was defined as biochemical recurrence-free survival (BRFS). Additionally, the association between BCR and clinicopathological covariates was determined.Results: We enrolled 2670 patients in this study. The median follow-up period was 26.0 months. RARP-related perioperative complications were identified in 198 patients (7.4%), including 69 patients (2.6%) with grade 3/4 complications according to the Clavien-Dindo classification. The 2-year BRFS was 88.0%.Using the Kaplan-Meier method, initial prostate-specific antigen (PSA) level of ≤7.6 ng/mL, biopsy and pathological Gleason score (GS) of ≤7, clinical and pathological T1/2, and low/intermediate risks according to the National Comprehensive Cancer Network risk classification, and negative surgical margin status had significant BRFS than their counterparts. In multivariate analysis, initial PSA, biopsy and pathological GS, clinical and pathological T stage, and surgical margin status significantly correlated with BCR after RARP. Conclusion: In this study, RARP achieved a lower incidence of perioperative complications than other studies. K E Y W O R D Soncological outcomes and perioperative complications, prostate cancer, robot-assisted radical prostatectomy

Complications of single‐port robot‐assisted radical prostatectomy: multi‐institutional analysis from the Single‐Port Advanced Research Consortium (SPARC)

“…The relatively low rates of intraoperative complications (0.4%), 90‐day postoperative complications (13%), and readmission (3.9%) appeared to be comparable to those of previous multi‐port RARP series (Table 3) [8–28]. As summarised in Table 3, there were significant heterogeneity in the reporting standards, especially with several studies reporting postoperative complications and readmissions within 30 days [9,13,14,16,17,19].…”

Short-term prognosis of low-risk prostate cancer patients is favorable despite the presence of pathological prognostic factors: a retrospective study

“…Prognostic factors for BCR of clinically or pathologically localized PCa are as follows: clinical factors, including age [ 2 ], PSA [ 3 ], and PSAD [ 4 ], and pathological factors, including GG [ 5 ], LVI[ 6 ], EPE [ 7 ], SM [ 8 ], SVI [ 9 ], IDCP [ 11 ], and pT [ 10 ]. In the overall risk analysis of the study participants, the presence of pathological prognostic factors significantly shortened BCR-free survival, as reported in a previous report.…”

“…Prognostic factors for biochemical recurrence (BCR) of clinically or pathologically localized PCa include clinical prognostic factors such as age [ 2 ], PSA [ 3 ], and PSAD [ 4 ], and pathological prognostic factors such as GG [ 5 ], lymphovascular invasion (LVI) [ 6 ], extraprostatic extensions (EPE) [ 7 ], surgical margins (SM) [ 8 ], seminal vesicle invasion (SVI) [ 9 ], and pT [ 10 ]. Additionally, intraductal carcinoma of the prostate (IDCP) has recently been considered an independent and strong prognostic factor [ 11 ].…”

Early and late urinary continence outcomes after unilateral and bilateral nerve‐sparing robot‐assisted radical prostatectomy: A retrospective multicentre cohort study in Japan (the MSUG94 group)

“…Robot-assisted laparoscopic radical prostatectomy (RARP) has become one of the standard treatments for localised disease as well as radiation therapy and active surveillance. 1 Urinary incontinence detrimentally affects patient quality of life and the incidence of urinary continence recovery (UCR) is reportedly higher after RARP than after open and laparoscopic radical prostatectomy (RP). 2 Reported incidence rates of urinary incontinence 12 months after RP, including RARP, range from 4% to 31%.…”