OBJECTIVES: To investigate pathological and oncological outcomes of obese patients who underwent robot-assisted radical prostatectomy (RARP) compared with laparoscopic radical prostatectomy (LRP) or open retropubic radical prostatectomy (RRP) since limited comparative data exist with regard to oncological and survival outcomes. METHODS: A total of 869 patients with body mass index ≥ 30 from two academic centers were identified. A total of 194 patients who underwent RARP were propensity score (PS) matched 1:1 to LRP or RRP cases. PS-matching variables included prostate-specific antigen (PSA), biopsy Gleason score, clinical stage, surgeon experience, and nerve-sparing technique. Predictors of positive surgical margins (PSMs) were analyzed using logistic regression. Predictors of recurrence-free survival (RFS) were analyzed within Cox regression models. Overall survival was compared with RFS using the log-rank test. RESULTS: Pathologic Gleason scores <7, =7, and >7 were found in 24.2, 63.6, and 11.7 % of patients, respectively. There were no statistically significant differences related to pathologic stage or lymph node metastases between surgical techniques. PSM for pT2 disease were observed in 22.9, 17.4, and 19.3 % of patients undergoing RARP, LRP, and RRP, respectively (not significantly different). Preoperative PSA and clinical stage cT2 disease were independently associated with PSM. There were no significant differences in mean 3-year RFS for RARP, LRP, and RRP (87.4, 91.0, and 85.7 %). Biopsy Gleason score >7, PSM, and clinical stage two were independent predictors of decreased RFS. CONCLUSIONS: RARP demonstrates similar pathological and oncological results compared with LRP or RRP for obese patients.
OBJECTIVES: To investigate pathological and oncological outcomes of obesepatients who underwent robot-assisted radical prostatectomy (RARP) compared with laparoscopic radical prostatectomy (LRP) or open retropubic radical prostatectomy (RRP) since limited comparative data exist with regard to oncological and survival outcomes. METHODS: A total of 869 patients with body mass index ≥ 30 from two academic centers were identified. A total of 194 patients who underwent RARP were propensity score (PS) matched 1:1 to LRP or RRP cases. PS-matching variables included prostate-specific antigen (PSA), biopsy Gleason score, clinical stage, surgeon experience, and nerve-sparing technique. Predictors of positive surgical margins (PSMs) were analyzed using logistic regression. Predictors of recurrence-free survival (RFS) were analyzed within Cox regression models. Overall survival was compared with RFS using the log-rank test. RESULTS: Pathologic Gleason scores <7, =7, and >7 were found in 24.2, 63.6, and 11.7 % of patients, respectively. There were no statistically significant differences related to pathologic stage or lymph node metastases between surgical techniques. PSM for pT2 disease were observed in 22.9, 17.4, and 19.3 % of patients undergoing RARP, LRP, and RRP, respectively (not significantly different). Preoperative PSA and clinical stage cT2 disease were independently associated with PSM. There were no significant differences in mean 3-year RFS for RARP, LRP, and RRP (87.4, 91.0, and 85.7 %). Biopsy Gleason score >7, PSM, and clinical stage two were independent predictors of decreased RFS. CONCLUSIONS: RARP demonstrates similar pathological and oncological results compared with LRP or RRP for obesepatients.
Authors: Vincenzo Ficarra; Giacomo Novara; Walter Artibani; Andrea Cestari; Antonio Galfano; Markus Graefen; Giorgio Guazzoni; Bertrand Guillonneau; Mani Menon; Francesco Montorsi; Vipul Patel; Jens Rassweiler; Hendrik Van Poppel Journal: Eur Urol Date: 2009-01-25 Impact factor: 20.096
Authors: Ahmed Magheli; Mark L Gonzalgo; Li-Ming Su; Thomas J Guzzo; George Netto; Elizabeth B Humphreys; Misop Han; Alan W Partin; Christian P Pavlovich Journal: BJU Int Date: 2010-11-02 Impact factor: 5.588
Authors: Quoc-Dien Trinh; Jesse Sammon; Maxine Sun; Praful Ravi; Khurshid R Ghani; Marco Bianchi; Wooju Jeong; Shahrokh F Shariat; Jens Hansen; Jan Schmitges; Claudio Jeldres; Craig G Rogers; James O Peabody; Francesco Montorsi; Mani Menon; Pierre I Karakiewicz Journal: Eur Urol Date: 2011-12-22 Impact factor: 20.096
Authors: Stephen A Boorjian; Paul L Crispen; Rachel E Carlson; Laureano J Rangel; R Jeffrey Karnes; Igor Frank; Matthew T Gettman Journal: J Endourol Date: 2008-07 Impact factor: 2.942
Authors: Tammy Ho; Leah Gerber; William J Aronson; Martha K Terris; Joseph C Presti; Christopher J Kane; Christopher L Amling; Stephen J Freedland Journal: Eur Urol Date: 2012-08-20 Impact factor: 20.096
Authors: Jim C Hu; Xiangmei Gu; Stuart R Lipsitz; Michael J Barry; Anthony V D'Amico; Aaron C Weinberg; Nancy L Keating Journal: JAMA Date: 2009-10-14 Impact factor: 56.272
Authors: Abbas Basiri; Jean Jmch de la Rosette; Shahin Tabatabaei; Henry H Woo; M Pilar Laguna; Hamidreza Shemshaki Journal: World J Urol Date: 2018-01-23 Impact factor: 4.226