Salvage robot assisted radical prostatectomy: A propensity matched study of perioperative, oncological and functional outcomes
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1016/j.ejso.2015.06.002 http://hdl.handle.net/11449/220465 |
Resumo: | Background To report the perioperative, functional and oncological outcomes of salvage robot-assisted laparoscopic prostatectomy (s-RARP) in a propensity score-matched analysis. Study design 53 patients underwent s-RARP at our institution. Perioperative, functional and oncological outcomes were compared between propensity matched cohorts. Results Patients in the s-RARP group were at significantly higher risk based on the D'Amico classification system (p = 0.010). Estimated blood loss, complication rate, hospital stay, BCR risk, persistent cancer and time to return of potency were similar between groups (full nerve spare [NS] n = 22). In the s-RARP cohort there was a higher prevalence of lymphovascular invasion (26.4% versus 13.2%; p = 0.032), time to catheter removal and a higher prevalence of anastomotic leaks in the postoperative period (34.0% vs 5.7%, p < 0.010). The hazard ratio for return to potency regardless of nerve sparing in the s-RARP group was 0.47 (95% CI 0.25-0.88). Significantly more patients undergoing primary RARP with partial nerve sparing (NS) recovered continence (p < 0.001) and potency (p = 0.043) compared to partial NS s-RARP patients. The return to continence and potency did not differ between full NS cases (n = 22; p = 0.616). Conclusions Salvage RARP patients undergoing surgery have more high risk disease. Patients should be counseled that they are more likely to demonstrate anastomotic leakage on cystogram, and prolonged catheterization times. The time to potency and continence in s-RARP undergoing partial and no NS was significantly delayed (n = 49). The proportion of patients returning to potency and continence was also lower in our s-RARP group. |
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Salvage robot assisted radical prostatectomy: A propensity matched study of perioperative, oncological and functional outcomesOncological outcomesPotencyRobotic assisted radical prostatectomySalvage prostatectomyUrinary incontinenceBackground To report the perioperative, functional and oncological outcomes of salvage robot-assisted laparoscopic prostatectomy (s-RARP) in a propensity score-matched analysis. Study design 53 patients underwent s-RARP at our institution. Perioperative, functional and oncological outcomes were compared between propensity matched cohorts. Results Patients in the s-RARP group were at significantly higher risk based on the D'Amico classification system (p = 0.010). Estimated blood loss, complication rate, hospital stay, BCR risk, persistent cancer and time to return of potency were similar between groups (full nerve spare [NS] n = 22). In the s-RARP cohort there was a higher prevalence of lymphovascular invasion (26.4% versus 13.2%; p = 0.032), time to catheter removal and a higher prevalence of anastomotic leaks in the postoperative period (34.0% vs 5.7%, p < 0.010). The hazard ratio for return to potency regardless of nerve sparing in the s-RARP group was 0.47 (95% CI 0.25-0.88). Significantly more patients undergoing primary RARP with partial nerve sparing (NS) recovered continence (p < 0.001) and potency (p = 0.043) compared to partial NS s-RARP patients. The return to continence and potency did not differ between full NS cases (n = 22; p = 0.616). Conclusions Salvage RARP patients undergoing surgery have more high risk disease. Patients should be counseled that they are more likely to demonstrate anastomotic leakage on cystogram, and prolonged catheterization times. The time to potency and continence in s-RARP undergoing partial and no NS was significantly delayed (n = 49). The proportion of patients returning to potency and continence was also lower in our s-RARP group.Global Robotics Institute Florida Hospital-Celebration Health University of Central Florida College of MedicineDepartment of Urology Fondazione Ospedale Maggiore Policlinico University of MilanUniversity of Sao Paulo State Cancer InstituteUniversity of Central Florida College of MedicineUniversity of MilanUniversidade de São Paulo (USP)Bates, A. S.Samavedi, S.Kumar, A.Mouraviev, V.Rocco, B.Coelho, R.Palmer, K.Patel, V. R.2022-04-28T19:01:38Z2022-04-28T19:01:38Z2015-11-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1540-1546http://dx.doi.org/10.1016/j.ejso.2015.06.002European Journal of Surgical Oncology, v. 41, n. 11, p. 1540-1546, 2015.1532-21570748-7983http://hdl.handle.net/11449/22046510.1016/j.ejso.2015.06.0022-s2.0-84943586853Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengEuropean Journal of Surgical Oncologyinfo:eu-repo/semantics/openAccess2022-04-28T19:01:38Zoai:repositorio.unesp.br:11449/220465Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-05T23:23:32.375441Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Salvage robot assisted radical prostatectomy: A propensity matched study of perioperative, oncological and functional outcomes |
title |
Salvage robot assisted radical prostatectomy: A propensity matched study of perioperative, oncological and functional outcomes |
spellingShingle |
Salvage robot assisted radical prostatectomy: A propensity matched study of perioperative, oncological and functional outcomes Bates, A. S. Oncological outcomes Potency Robotic assisted radical prostatectomy Salvage prostatectomy Urinary incontinence |
title_short |
Salvage robot assisted radical prostatectomy: A propensity matched study of perioperative, oncological and functional outcomes |
title_full |
Salvage robot assisted radical prostatectomy: A propensity matched study of perioperative, oncological and functional outcomes |
title_fullStr |
Salvage robot assisted radical prostatectomy: A propensity matched study of perioperative, oncological and functional outcomes |
title_full_unstemmed |
Salvage robot assisted radical prostatectomy: A propensity matched study of perioperative, oncological and functional outcomes |
title_sort |
Salvage robot assisted radical prostatectomy: A propensity matched study of perioperative, oncological and functional outcomes |
author |
Bates, A. S. |
author_facet |
Bates, A. S. Samavedi, S. Kumar, A. Mouraviev, V. Rocco, B. Coelho, R. Palmer, K. Patel, V. R. |
author_role |
author |
author2 |
Samavedi, S. Kumar, A. Mouraviev, V. Rocco, B. Coelho, R. Palmer, K. Patel, V. R. |
author2_role |
author author author author author author author |
dc.contributor.none.fl_str_mv |
University of Central Florida College of Medicine University of Milan Universidade de São Paulo (USP) |
dc.contributor.author.fl_str_mv |
Bates, A. S. Samavedi, S. Kumar, A. Mouraviev, V. Rocco, B. Coelho, R. Palmer, K. Patel, V. R. |
dc.subject.por.fl_str_mv |
Oncological outcomes Potency Robotic assisted radical prostatectomy Salvage prostatectomy Urinary incontinence |
topic |
Oncological outcomes Potency Robotic assisted radical prostatectomy Salvage prostatectomy Urinary incontinence |
description |
Background To report the perioperative, functional and oncological outcomes of salvage robot-assisted laparoscopic prostatectomy (s-RARP) in a propensity score-matched analysis. Study design 53 patients underwent s-RARP at our institution. Perioperative, functional and oncological outcomes were compared between propensity matched cohorts. Results Patients in the s-RARP group were at significantly higher risk based on the D'Amico classification system (p = 0.010). Estimated blood loss, complication rate, hospital stay, BCR risk, persistent cancer and time to return of potency were similar between groups (full nerve spare [NS] n = 22). In the s-RARP cohort there was a higher prevalence of lymphovascular invasion (26.4% versus 13.2%; p = 0.032), time to catheter removal and a higher prevalence of anastomotic leaks in the postoperative period (34.0% vs 5.7%, p < 0.010). The hazard ratio for return to potency regardless of nerve sparing in the s-RARP group was 0.47 (95% CI 0.25-0.88). Significantly more patients undergoing primary RARP with partial nerve sparing (NS) recovered continence (p < 0.001) and potency (p = 0.043) compared to partial NS s-RARP patients. The return to continence and potency did not differ between full NS cases (n = 22; p = 0.616). Conclusions Salvage RARP patients undergoing surgery have more high risk disease. Patients should be counseled that they are more likely to demonstrate anastomotic leakage on cystogram, and prolonged catheterization times. The time to potency and continence in s-RARP undergoing partial and no NS was significantly delayed (n = 49). The proportion of patients returning to potency and continence was also lower in our s-RARP group. |
publishDate |
2015 |
dc.date.none.fl_str_mv |
2015-11-01 2022-04-28T19:01:38Z 2022-04-28T19:01:38Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1016/j.ejso.2015.06.002 European Journal of Surgical Oncology, v. 41, n. 11, p. 1540-1546, 2015. 1532-2157 0748-7983 http://hdl.handle.net/11449/220465 10.1016/j.ejso.2015.06.002 2-s2.0-84943586853 |
url |
http://dx.doi.org/10.1016/j.ejso.2015.06.002 http://hdl.handle.net/11449/220465 |
identifier_str_mv |
European Journal of Surgical Oncology, v. 41, n. 11, p. 1540-1546, 2015. 1532-2157 0748-7983 10.1016/j.ejso.2015.06.002 2-s2.0-84943586853 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
European Journal of Surgical Oncology |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
1540-1546 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
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1808129515285643264 |