OBJECTIVE: To evaluate the trifecta outcome and its preoperative predictors in a series of consecutive patients who underwent robot-assisted laparoscopic radical prostatectomy (RALP). PATIENTS AND METHODS: We collected prospectively the clinical data of 242 consecutive patients with a minimum 12-month follow-up undergoing RALP for clinically localized prostate cancer. International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and the International Index of Erectile Function (IIEF)-6 were used to evaluate the functional outcomes. Patients receiving adjuvant therapies or with a PSA at follow-up > 0.2 ng/mL were censored for the biochemical recurrence-free analysis. Logistic regression was used to perform univariable and multivariable analyses. RESULTS: Twelve months after surgery, 216 patients (89%) were continent and 145 (60%) were potent. At a median follow-up of 14 mo, 11 patients (4.5%) had either adjuvant radiation therapies within 3 months of surgery, when PSA was still undetectable (n= 6, 2.5%), or salvage radiation or hormone plus radiation therapy for PSA relapse (n= 5, 2%). A trifecta outcome was achieved by 137 patients (57%). On univariable regression analysis, patients' age at surgery (P < 0.001), body-mass index (P= 0.028), preoperative IIEF-6 score (P < 0.001) and prostate volume (P= 0.036) were significantly associated with trifecta rates. On multivariable analysis, only patients' age at surgery (odds ratio 1.095; P= 0.005) and preoperative IIEF-6 score (odds ratio 0.803; P < 0.001) were independent predictors of trifecta rates. CONCLUSION: Using validated questionnaires to assess functional outcomes, we found that 57% of our patients undergoing nerve-sparing RALP achieved the trifecta outcome 12 months after surgery. Patient age at surgery and preoperative erectile function were the only independent predictors of trifecta rates.
OBJECTIVE: To evaluate the trifecta outcome and its preoperative predictors in a series of consecutive patients who underwent robot-assisted laparoscopic radical prostatectomy (RALP). PATIENTS AND METHODS: We collected prospectively the clinical data of 242 consecutive patients with a minimum 12-month follow-up undergoing RALP for clinically localized prostate cancer. International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and the International Index of Erectile Function (IIEF)-6 were used to evaluate the functional outcomes. Patients receiving adjuvant therapies or with a PSA at follow-up > 0.2 ng/mL were censored for the biochemical recurrence-free analysis. Logistic regression was used to perform univariable and multivariable analyses. RESULTS: Twelve months after surgery, 216 patients (89%) were continent and 145 (60%) were potent. At a median follow-up of 14 mo, 11 patients (4.5%) had either adjuvant radiation therapies within 3 months of surgery, when PSA was still undetectable (n= 6, 2.5%), or salvage radiation or hormone plus radiation therapy for PSA relapse (n= 5, 2%). A trifecta outcome was achieved by 137 patients (57%). On univariable regression analysis, patients' age at surgery (P < 0.001), body-mass index (P= 0.028), preoperative IIEF-6 score (P < 0.001) and prostate volume (P= 0.036) were significantly associated with trifecta rates. On multivariable analysis, only patients' age at surgery (odds ratio 1.095; P= 0.005) and preoperative IIEF-6 score (odds ratio 0.803; P < 0.001) were independent predictors of trifecta rates. CONCLUSION: Using validated questionnaires to assess functional outcomes, we found that 57% of our patients undergoing nerve-sparing RALP achieved the trifecta outcome 12 months after surgery. Patient age at surgery and preoperative erectile function were the only independent predictors of trifecta rates.
Authors: Georgios Hatzichristodoulou; Stefan Wagenpfeil; Gudrun Wagenpfeil; Tobias Maurer; Thomas Horn; Kathleen Herkommer; Marie Hegemann; Jürgen E Gschwend; Hubert Kübler Journal: World J Urol Date: 2015-09-29 Impact factor: 4.226
Authors: Low Wei Xiang Alvin; Sim Hong Gee; Huang Hong Hong; Cheng Wai Sam Christopher; Ho Sien Sun Henry; Lau Kam On Weber; Tan Puay Hoon; Lee Lui Shiong Journal: J Robot Surg Date: 2015-07-07
Authors: Francesco Soria; B Pradere; R Hurle; D D'Andrea; S Albisinni; R Diamand; E Laukhtina; E Di Trapani; A Aziz; W Krajewski; J Y Teoh; A Mari; M Moschini; F Chiancone; R Autorino; A Porreca; M Marchioni; G Liguori; G Lucarelli; G M Busetto; N Foschi; A Antonelli; P Bove; G I Russo; N Crisan; M Borghesi; L Boeri; A Veccia; F Greco; N Longo; O De Cobelli; S F Shariat; P Gontero; M Ferro Journal: Eur Urol Open Sci Date: 2022-06-13