A Matched Analysis of Salvage Robotic Assisted Radical Prostatectomy
BAUS ePoster online library. Noel J. 06/21/21; 319067; p2-9
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Mr. Jonathan Noel
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Abstract
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Focal therapy for prostate cancer has gained popularity given its relative noninvasiveness. We evaluated the impact of focal therapy on functional and oncological outcomes following robotic assisted radical prostatectomy (RARP)
Materials and methods:
53 patients who had prostatectomy following the failure of focal ablation were selected as the focal group. They were compared to a matched control sample of the ratio of 1:1 with the RARP cohort. Age, PSA, PSA density, BMI, SHIM, AUA, Charlson Comorbidity Index, Prostate weight, Preoperative Gleason score, and history of Smoking were used to perform matching. The oncological and functional outcomes between these groups were compared.
Results:
No difference in EBL and OR time was noted between the focal and control group. More full NS and partial NS were performed in the control group compared to the focal group (p<0.001). The focal therapy group had a higher incidence of positive surgical margin (35.8% vs 15.1%, p = 0.04).Also, the focal therapy group had higher incidence of GS >= 8 ( 28.3% vs 17%, p = 0.07) and positive lymph node status ( 73.5% vs 9.4%, p =0.02). The focal therapy group had a higher incidence of lymphocele drainage post-surgery (15.1 vs 0, p = 0.006).
Fig 1 shows CIF comparing the continence, potency, and biochemical recurrence in 1:1.
Conclusions:
Salvage robotic-assisted radical prostatectomy after focal therapy failure is feasible however, surgery following focal therapy leads to poorer oncological and functional outcomes. This scenario needs to be discussed with the patient's prior focal therapy counselling
Materials and methods:
53 patients who had prostatectomy following the failure of focal ablation were selected as the focal group. They were compared to a matched control sample of the ratio of 1:1 with the RARP cohort. Age, PSA, PSA density, BMI, SHIM, AUA, Charlson Comorbidity Index, Prostate weight, Preoperative Gleason score, and history of Smoking were used to perform matching. The oncological and functional outcomes between these groups were compared.
Results:
No difference in EBL and OR time was noted between the focal and control group. More full NS and partial NS were performed in the control group compared to the focal group (p<0.001). The focal therapy group had a higher incidence of positive surgical margin (35.8% vs 15.1%, p = 0.04).Also, the focal therapy group had higher incidence of GS >= 8 ( 28.3% vs 17%, p = 0.07) and positive lymph node status ( 73.5% vs 9.4%, p =0.02). The focal therapy group had a higher incidence of lymphocele drainage post-surgery (15.1 vs 0, p = 0.006).
Fig 1 shows CIF comparing the continence, potency, and biochemical recurrence in 1:1.
Conclusions:
Salvage robotic-assisted radical prostatectomy after focal therapy failure is feasible however, surgery following focal therapy leads to poorer oncological and functional outcomes. This scenario needs to be discussed with the patient's prior focal therapy counselling
Focal therapy for prostate cancer has gained popularity given its relative noninvasiveness. We evaluated the impact of focal therapy on functional and oncological outcomes following robotic assisted radical prostatectomy (RARP)
Materials and methods:
53 patients who had prostatectomy following the failure of focal ablation were selected as the focal group. They were compared to a matched control sample of the ratio of 1:1 with the RARP cohort. Age, PSA, PSA density, BMI, SHIM, AUA, Charlson Comorbidity Index, Prostate weight, Preoperative Gleason score, and history of Smoking were used to perform matching. The oncological and functional outcomes between these groups were compared.
Results:
No difference in EBL and OR time was noted between the focal and control group. More full NS and partial NS were performed in the control group compared to the focal group (p<0.001). The focal therapy group had a higher incidence of positive surgical margin (35.8% vs 15.1%, p = 0.04).Also, the focal therapy group had higher incidence of GS >= 8 ( 28.3% vs 17%, p = 0.07) and positive lymph node status ( 73.5% vs 9.4%, p =0.02). The focal therapy group had a higher incidence of lymphocele drainage post-surgery (15.1 vs 0, p = 0.006).
Fig 1 shows CIF comparing the continence, potency, and biochemical recurrence in 1:1.
Conclusions:
Salvage robotic-assisted radical prostatectomy after focal therapy failure is feasible however, surgery following focal therapy leads to poorer oncological and functional outcomes. This scenario needs to be discussed with the patient's prior focal therapy counselling
Materials and methods:
53 patients who had prostatectomy following the failure of focal ablation were selected as the focal group. They were compared to a matched control sample of the ratio of 1:1 with the RARP cohort. Age, PSA, PSA density, BMI, SHIM, AUA, Charlson Comorbidity Index, Prostate weight, Preoperative Gleason score, and history of Smoking were used to perform matching. The oncological and functional outcomes between these groups were compared.
Results:
No difference in EBL and OR time was noted between the focal and control group. More full NS and partial NS were performed in the control group compared to the focal group (p<0.001). The focal therapy group had a higher incidence of positive surgical margin (35.8% vs 15.1%, p = 0.04).Also, the focal therapy group had higher incidence of GS >= 8 ( 28.3% vs 17%, p = 0.07) and positive lymph node status ( 73.5% vs 9.4%, p =0.02). The focal therapy group had a higher incidence of lymphocele drainage post-surgery (15.1 vs 0, p = 0.006).
Fig 1 shows CIF comparing the continence, potency, and biochemical recurrence in 1:1.
Conclusions:
Salvage robotic-assisted radical prostatectomy after focal therapy failure is feasible however, surgery following focal therapy leads to poorer oncological and functional outcomes. This scenario needs to be discussed with the patient's prior focal therapy counselling
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