2018, Number 1
Rev Mex Urol 2018; 78 (1)
Gil-Villa SA, Campos-Salcedo JG, López-Silvestre JC, Estrada-Carrasco CE, Mendoza-Álvarez LA, Díaz-Gómez C
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ABSTRACTBackground: Twenty to 30% of prostate cancer patients present with high-risk disease. Treatment is controversial, and the trend today is toward multimodal management, with radical prostatectomy as the initial step.
Objective: To report the results of robotic-assisted radical prostatectomy in patients with high-risk localized prostate cancer.
Materials and Methods: A retrospective, descriptive, observational, and longitudinal study was conducted on patients with at least one high-risk criterion (prostate-specific antigen ≥ 20 ng/mL, clinical stage ≥ T2c and/or Gleason score ≥ 8) that underwent robotic-assisted radical prostatectomy. Preoperative and perioperative variables were evaluated, along with the oncologic and functional follow-up data, and measures of central tendency were used for the statistical analysis with the SPSS program.
Results: Of the 128 case records retrieved, 21 of those patients met at least one high-risk criterion. The most common criterion was a Gleason score › 8 (52.4%). Mean patient age was 68.9 years; prostatespecific antigen, 19 ng/mL; surgery duration, 300.2 min; blood loss, 494.8 mL; and transfusion rate, 4.8%. The complication rate was 33%; hospital stay, 6.9 days; time with catheter, 13.9 days; positive surgical margins, 47.6%; biochemical recurrence, 28.6%; adjuvant therapy, 38.1%; and preserved continence and erectile function were 58.8 and 47%, respectively, at month 12 of follow-up.
Conclusions: Robotic-assisted radical prostatectomy is a safe, minimally invasive procedure, with low morbidity and satisfactory perioperative and functional results. Additional studies and long-term follow-up are required.