Also available in: Español
Rev Mex Urol. 2018 January-February;78(1):8-16. DOI: https://doi.org/10.24245/revmexurol.v78i1.1674
Gil-Villa SA, Campos-Salcedo JG, López-Silvestre JC, Estrada-Carrasco CE, Mendoza-Álvarez LA, Díaz-Gómez C et al.
Urology Service, Hospital Central Militar, Mexico City, Mexico.
BACKGROUND: 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: The aim of the present study was 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 (PSA ≥ 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%). In means, patient age was 68.9 years; PSA, 19 ng/mL; surgical 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 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.
KEYWORDS: Prostate cancer; Radical prostatectomy; Robotic-assisted surgery.
Sergio Alberto Gil Villa