Objective: To compare the outcomes between a modified Retzius-sparing robot-assisted radical prostatectomy (mRS-RARP) technique and conventional robot-assisted radical prostatectomy (Con-RARP) technique for cases with anterior prostate cancer (PCa), especially positive surgical margin (PSM) rates and urinary continence (UC).
Patients And Methods: We retrospectively included 193 mRS-RARP and 473 Con-RARP consecutively performed by a single surgeon for anterior PCa. Perioperative complications, pathology, and continence were compared after propensity score matching using 9 variables.
Results: After matching (n = 193 per group), PSM were not significantly different in the two groups (16.1% in mRS-RARP group vs. 15.0% in Con-RARP group, p = 0.779). The UC at catheter removal and at 1-month was significantly higher in the mRS-RARP (24.9% vs. 9.8%, p < 0.001; 29.0% vs. 13.5%, p < 0.001, respectively), but not at 3-, 6-, and 12-month follow-ups (p = 0.261, 0.832, and 0.683, respectively).
Conclusion: mRS-RARP seems to be an oncologically safe approach for patients with anterior PCa. Compared with the conventional approach, mRS-RARP approach shows benefits in the short-term postoperative UC recovery.
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http://dx.doi.org/10.1007/s00345-024-04807-7 | DOI Listing |
Prostate Int
September 2024
Department of Urology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Japan.
Background: Despite providing valuable staging and prognostic information, the therapeutic benefit of pelvic lymph node dissection (PLND) remains uncertain. We sought to assess the effect of extended PLND (ePLND) on the biochemical recurrence (BCR) of patients with National Comprehensive Cancer Net (NCCN) high- or very high-risk prostate cancer treated via robot-assisted radical prostatectomy (RARP).
Methods: We used a multi-institutional database (six centers) to assess 989 patients who underwent RARP from 2014 to 2022 with or without ePLND, among which 699 patients underwent BCR analysis.
Sci Rep
January 2025
Department of Urology, Kyoto University School of Medicine, 54 Shougoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
This study evaluated the impact of aspirin on the biochemical recurrence (BCR) rate following robot-assisted radical prostatectomy (RARP) in patients. A database search identified patients who underwent RARP for pT2-3N0M0 disease at any of 25 centers between 2011 and 2022, categorized into aspirin (n = 350) and control groups (n = 5857). Adjustment by 1:1 propensity score matching (PSM) and Mahalanobis distance matching (MDM) created 350 matched pairs.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
Prostate cancer (PCa) is one of the most common cancers among men worldwide, and robot-assisted radical prostatectomy (RARP) is a widely used treatment for localized PCa. Achieving pentafecta outcomes, which include continence, potency, cancer control, free surgical margins, and no major complications, is a critical measure of surgical success and long-term prognosis. However, predicting these outcomes remains challenging.
View Article and Find Full Text PDFUrology
January 2025
Department of Urology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China; Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. Electronic address:
Objectives: To explore new metrics for assessing radical prostatectomy difficulty through a two-stage deep learning method from preoperative magnetic resonance imaging.
Methods: The procedure and metrics were validated through 290 patients consisting of laparoscopic and robot-assisted radical prostatectomy procedures from two real cohorts. The nnUNet_v2 adaptive model was trained to perform accurate segmentation of the prostate and pelvis.
Langenbecks Arch Surg
January 2025
Department for the Promotion of Medical Device Innovation, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Purpose: Assessing surgical skills is vital for training surgeons, but creating objective, automated evaluation systems is challenging, especially in robotic surgery. Surgical procedures generally involve dissection and exposure (D/E), and their duration and proportion can be used for skill assessment. This study aimed to develop an AI model to acquire D/E parameters in robot-assisted radical prostatectomy (RARP) and verify if these parameters could distinguish between novice and expert surgeons.
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