Prospective evaluation of pentafecta outcomes at 5 years after laparoscopic radical prostatectomy: results of 170 patients at a single center

Abstract

A new and more comprehensive methodology for reporting outcomes after radical prostatectomy (RP) has been proposed: the so-called pentafecta. However, no prior studies reported intermediate- and long-term pentafecta outcomes after laparoscopic RP. We collected prospectively the clinical data of 170 consecutive patients with a minimum 60-month follow-up undergoing laparoscopic RP for clinically localized prostate cancer. International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and the Sexual Health Inventory for Men score were used to evaluate the functional outcomes. Logistic regression was used to perform univariable and multivariable analyses. Sixty months after surgery, a pentafecta outcome was achieved by 124 patients (72.9%). On univariable regression analysis, patient age at surgery (P<0.001), body mass index (P=0.031), pathological T stage (P<0.001) and prostate volume (P=0.003) were significantly associated with pentafecta rates. On multivariable analysis, only patient age at surgery (odds ratio 0.95; P=0.006) and pathological T stage (odds ratio 0.82; P<0.001) were independent predictors of pentafecta rates. Using validated questionnaires to assess functional outcomes, for the first time, we evaluated pentafecta outcomes at 5 years after laparoscopic RP. This approach may be beneficial and could be used when counseling patients with clinically localized prostate cancer.