Laparoscopic/ Robotic: Prostate
Moderated Poster Session
MP18-7 - Short term Oncological and functional outcomes of Retzius sparing Prostatectomy in High risk prostate cancer: A matched cohort analysis
Saturday, September 22
10:00 AM - 12:00 PM
Location: Room 253
Introduction & Objective :
Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) appears to produce significantly better early urinary continence than its non-RS counterpart but concerns exist that it might not allow a sufficiently wide excision of the prostate when needed and might therefore be unsuitable for higher risk prostate cancers.We report our short term functional and oncological outcomes in patients who underwent Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) for high risk prostate cancer
Between May 2016 and September 2017,160 patients underwent RS-RARP.55 patients had high risk prostate according to the D’Amico classification.All patients had extended pelvic lymphadenectomy. Matched group analysis of 55 high-risk patients operated on robotically by the same surgeon.Post-operative complications, functional and short term oncological outcomes were compared.Positive margins and biochemical recurrence were analyzed as a surrogate for short termonological outcomes were also compared.
The mean follow-up in RS- and non-RS-RARP patients was 8 (1-16) months & 24 (16-33) months.The median duration of catheterization (9 vs 14 days) was shorter in the RS group 71% of whom had a suprapubic catheter inserted.Positive surgical margin and biochemical recurrence were similar in both groupsThe 4-week pad-free rates were 73.0% and 7.3%
RS-RARP produces dramatically better (10x) urinary continence at 4 weeks than non-RS-RARP and does not appear to negatively impact short-terms indicators of cancer control in patients with high-risk prostate cancer.Clearly longer follow-up is needed to determine its impact on cancer control.