Martin Baunacke1, Maria-Luisa Schmidt1, Christian Thomas1, Christer Groeben1, Angelika Borkowetz1, Rainer Koch1, Felix Kh Chun2, Lothar Weissbach3, Johannes Huber4. 1. Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany. 2. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany. 3. Health Research for Men GmbH, gfm, Berlin, Germany. 4. Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany. johannes.huber@uniklinikum-dresden.de.
Abstract
PURPOSE: To compare long-term functional outcomes after robotic vs. retropubic RP for patients with localized prostate cancer in routine care. METHODS: "HAROW" was a large German noninterventional health services research study that prospectively evaluated the treatment of patients with localized prostate cancer (≤ T2c). We sent validated questionnaires to 1260 patients who underwent RP to evaluate long-term outcomes. RESULTS: After a median follow-up of 6.3 [interquartile range (IQR) 4.8-7.6] years, 42 (3%) patients had died. The return rate of the questionnaire was 76.8% (936/1218). The approach was robotic in 404 and retropubic in 532 patients. In the multivariate analysis, lack of postoperative radiotherapy [odds ratio (OR) 3.1], younger patient age (< 60 years: OR 2.8; 60-69 years: OR 2.1), preoperative urinary continence (OR 2.4), and higher annual hospital caseload (≥ 200 cases: OR 1.6) were independent predictors of urinary continence. The potency rate after nerve-sparing RP in preoperatively potent men was 40.5% (111/274). In the multivariate analysis, younger patient age (< 60 years: OR 17.9; 60-69 years: OR 8.0), lower oncologic risk (OR 2.8), and lack of postoperative radiotherapy (OR 2.2) were independent predictors of potency. CONCLUSION: Younger age and lack of postoperative radiotherapy were associated with better urinary continence and erectile function. Additionally, a high annual caseload (≥ 200 RP/year) was associated with better urinary continence. Younger age, low or intermediated oncological risk and lack of postoperative radiotherapy were independent predictors for a trifecta outcome. The surgical approach did not affect long-term functional outcomes.
PURPOSE: To compare long-term functional outcomes after robotic vs. retropubic RP for patients with localized prostate cancer in routine care. METHODS: "HAROW" was a large German noninterventional health services research study that prospectively evaluated the treatment of patients with localized prostate cancer (≤ T2c). We sent validated questionnaires to 1260 patients who underwent RP to evaluate long-term outcomes. RESULTS: After a median follow-up of 6.3 [interquartile range (IQR) 4.8-7.6] years, 42 (3%) patients had died. The return rate of the questionnaire was 76.8% (936/1218). The approach was robotic in 404 and retropubic in 532 patients. In the multivariate analysis, lack of postoperative radiotherapy [odds ratio (OR) 3.1], younger patient age (< 60 years: OR 2.8; 60-69 years: OR 2.1), preoperative urinary continence (OR 2.4), and higher annual hospital caseload (≥ 200 cases: OR 1.6) were independent predictors of urinary continence. The potency rate after nerve-sparing RP in preoperatively potent men was 40.5% (111/274). In the multivariate analysis, younger patient age (< 60 years: OR 17.9; 60-69 years: OR 8.0), lower oncologic risk (OR 2.8), and lack of postoperative radiotherapy (OR 2.2) were independent predictors of potency. CONCLUSION: Younger age and lack of postoperative radiotherapy were associated with better urinary continence and erectile function. Additionally, a high annual caseload (≥ 200 RP/year) was associated with better urinary continence. Younger age, low or intermediated oncological risk and lack of postoperative radiotherapy were independent predictors for a trifecta outcome. The surgical approach did not affect long-term functional outcomes.
Authors: Markus A Küper; Alexander Trulson; Jonas Johannink; Bernhard Hirt; Artur Leis; Max Hoßfeld; Tina Histing; Steven C Herath; Bastian Amend Journal: J Robot Surg Date: 2022-02-11
Authors: Antonio Cordeiro da Silva Filho; Tamara Oliveira Rocha; Jorge Elias; Marcus Vinicius de Castro Barros; Alfredo Ribeiro Silva; Rodolfo Borges Dos Reis; Valdair Francisco Muglia Journal: Radiol Bras Date: 2020 Nov-Dec
Authors: Markus Maier; Anne-Karoline Ebert; Martin Baunacke; Christer Groeben; Nicole Eisenmenger; Christian Thomas; Johannes Huber Journal: Urologe A Date: 2021-09-15 Impact factor: 0.639
Authors: Martin Baunacke; Maria-Luisa Schmidt; Christer Groeben; Angelika Borkowetz; Christian Thomas; Rainer Koch; Falk Hoffmann; Felix K H Chun; Lothar Weissbach; Johannes Huber Journal: World J Urol Date: 2020-12-01 Impact factor: 4.226