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Comparative Study
. 2020 Nov;38(11):2791-2798.
doi: 10.1007/s00345-020-03096-0. Epub 2020 Feb 7.

Functional and perioperative outcomes in elderly men after robotic-assisted radical prostatectomy for prostate cancer

Samer L Traboulsi  1 , David-Dan Nguyen  2 , Ahmed S Zakaria  1 , Kyle W Law  2 , Hanna Shahine  1 , Malek Meskawi  1 , Cristina Negrean  1 , Pierre I Karakiewicz  1 , Assaad El Hakim  3 , Kevin C Zorn  4
Affiliations
Comparative Study

Functional and perioperative outcomes in elderly men after robotic-assisted radical prostatectomy for prostate cancer

Samer L Traboulsi et al. World J Urol. 2020 Nov.

Abstract

Purpose: We aimed to compare postoperative functional outcomes following robotic-assisted radical prostatectomy (RARP) in elderly men with localized prostate cancer.

Methods: A retrospective review of a prospectively maintained database of men who underwent RARP between January 2007 and November 2018 was performed. Patients over 65 years of age were selected (N = 302) and then stratified by age group: 66-69 years old (N = 214) and ≥ 70 years old (N = 88). Full continence was defined as strict 0-pad per day usage. Preoperative potency included those with a Sexual Health Inventory for Men score ≥ 17. Preoperative and postoperative functional outcomes were assessed. Kaplan-Meier analysis was used to estimate time to recovery of continence in both groups.

Results: Both groups had comparable preoperative parameters. Continence rates at 1, 3, 6, 9, 12, 18 and 24 months in the 66-69-year-old group were 6%, 34%, 61%, 70%, 74%, 80% and 87%, respectively. Comparatively in the ≥ 70-year-old group, continence rates were significantly lower at all time points (3%, 22%, 50%, 56%, 66%, 69% and 75%, respectively). Men in the 66-69-year-old group were significantly more likely to be continent after RARP when compared to patients 70 years of age and above [(Hazards ratio (HR) 0.73; 95%confidence interval 0.54-0.97, (p = 0.035)].

Conclusion: Our results suggest that RARP is feasible in elderly patients. Nevertheless, elderly patients in the ≥ 70-year-old group had significantly inferior postoperative continence rates compared to patients aged 66-69 years. Such information is valuable when counselling men during preoperative RARP planning to ensure that they have realistic postoperative expectations.

Keywords: Continence; Outcomes; Potency; Prostate cancer; Robotic-assisted radical prostatectomy.

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