Are robot-assisted radical prostatectomies safe in patients over 65?
Authors:
prof. MUDr. Miloš Bro Ák, Ph.D.; MUDr. Josef Košina; MUDr. Michal Balík; MUDr. Petr Hušek; MUDr. Lukáš Holub; MUDr. Jaroslav Pacovský, Ph.D.
Authors‘ workplace:
Urologická klinika LF UK a FN Hradec Králové
Published in:
Geriatrie a Gerontologie 2019, 8, č. 2: 53-58
Category:
Original Article
Overview
Introduction. Radical prostatectomy is the most effective treatment method for prostate cancer. A robot-assisted approach is a minimally invasive method that is highly effective and also suitable for elderly patients. The cohort of patients who underwent robot-assisted radical prostatectomy over 65 years of age was retrospectively evaluated.
Material and Methodology. The evaluated group had 256 patients, and all underwent robot-assisted radical prostatectomy in the period 2016-2018. Surgical outcomes and complications were evaluated. Furthermore, the functional and preliminary oncologic results of this group were analysed.
Results. Median follow-up time was 18 months. The operating time was 186 minutes and the blood losses were 150 ml. The most common length of hospitalization was 3 or 4 days. Only two patients were temporarily transferred to the ICU after surgery. Urinary incontinence was recorded in 10% patients and urethral stricture in 0.7%. According to our preliminary oncologic results, overall survival was 100% and overall and cancer-specific mortality was zero. Only one patient had serious complications with the need for repeated reoperations.
Conclusion. Robot-assisted radical prostatectomy is also very suitable for elderly patients. The patient’s age only would not be the most important criterion.
Keywords:
prostate cancer – robot-assisted radical prostatectomy – elderly patients
Sources
1. www.svod.cz
2. Hora M, Babjuk M, Broďák M, et al. Stěžejní urologické operační výkony v urologii v ČR v letech 2009–2014. Czech Urol 2016, 20; 135–140.
3. Marcq G, Michelet A, Hannink G, et al. Risk of biochemical recurrence based on extent and location of positive surgical margins after robot assisted laparoscopic radical prostatectomy. BMC Cancer 2018; 18: 1291–1297.
4. Balík M, Broďák M. Lokalizovaný karcinom prostaty – diagnostika a léčba. Urol praxi 2011; 12: 105–110.
5. Robinson D, Garmo H, Lissbrant IF, et al. Prostate Cancer Death after Radiotherapy or Radical Prostatectomy: A Nationwide Population-based Observational Study Eur Urol 2018; 73: 502–511.
6. Ilic D, Evans SM, Allan CA, et al. Laparoscopic and robot-assisted vs open radical prostatectomy for the treatment of localized prostate cancer: a Cochrane systematic review. BJU Int 2018; 121: 845–853.
7. Sooriakumaran P, Pini G, Nyberg T, et al. Erectile Function and Oncologic Outcomes Following Open Retropubic and Robot-assistedRadical Prostatectomy: Results from the LAParoscopic Prostatectomy Robot Open Trial. Eur Urol 2018; 73: 618–627.
8. Babaian KN, Skarecky D, Liss MA, et al. A comparative analysis of complications after robot-assisted radical prostatectomy for men aged ≤69 and ≥70 years. J Endourol 2014; 28: 1435–1438.
Labels
Geriatrics General practitioner for adults Orthopaedic prostheticsArticle was published in
Geriatrics and Gerontology
2019 Issue 2
Most read in this issue
- Risk and complications of the robotic partial nephrectomy in patients in age over 65 years
- The treatment of the water and electrolyte disturbances in geriatric patients.
- TRUS/MRI fusion prostate biopsy in patient over 65 years – results and complication rate analysis.
- Are robot-assisted radical prostatectomies safe in patients over 65?