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Long-term evaluation of survival, continence and potency (SCP) outcomes after robot-assisted radical prostatectomy (RARP).
BJU Int. 2013 Aug; 112(3):338-45.BI

Abstract

OBJECTIVE

To report combined oncological and functional outcome in a series of patients who underwent robot-assisted radical prostatectomy (RARP) for clinically localised prostate cancer in a single European centre after 5-year minimum follow-up according to survival, continence and potency (SCP) outcomes.

PATIENTS AND METHODS

We extracted from our prostate cancer database all consecutive patients with a minimum follow-up of 5 years after RARP. Biochemical failure was defined as a confirmed PSA concentration of >0.2 ng/mL. All patients alive at the last follow-up were evaluated for functional outcomes using the Expanded Prostate Cancer Index Composite (EPIC) and Sexual Health Inventory for Men (SHIM) questionnaires. Oncological and functional outcomes were reported according to the SCP system. Specifically, patients were classified as using no pad (C0), using one pad for security (C1), and using ≥1 pad (C2) (not including the prior definition). Patients potent (SHIM score of >17) without any aids were classified as P0 category; patients potent (SHIM score of >17) with use of phosphodiesterase type 5 inhibitorsas P1; and patients with erectile dysfunction (SHIM score of <17) as P2 category. Patients who did not undergo a nerve-sparing technique, who were not potent preoperatively, who were not interested in erections, or who did not have sexual partners were classified as Px category.

RESULTS

The 3-, 5- and 7-year biochemical recurrence-free survival rates were 96.3%; 89.6% and 88.3%, respectively. At follow-up, 146 (79.8%) were fully continent (C0), 20 (10.9%) still used a safety pad (C1) and 17 (9.3%) were incontinent using ≥1 pad (C2). Excluding Px patients, 52 patients (47.3%) were classified as P0; 41 patients (37.3%) were classified as P1 and 17 patients (15.5%) were P2. In patients preoperatively continent and potent, who received a nerve-sparing technique and did not require any adjuvant therapy, oncological and functional success was attained by 77 (80.2%) patients. In the subgroup of 67 patients not evaluable for potency recovery (Px), oncological and continence outcomes were attained in 46 patients (68.7%).

CONCLUSIONS

Oncological and functional success was attained in a high percentage of patients who underwent RARP at ≥5 years follow-up. Interestingly, this study confirmed that excellent oncological and functional outcomes can be obtained in the 'best' category of patients, i.e. those preoperatively continent and potent and with tumour characteristics suitable for a nerve-sparing technique.

Authors+Show Affiliations

OLV Robotic Surgery Institute, Aalst, Belgium. vincenzo.ficarra@unipd.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23470027

Citation

Ficarra, Vincenzo, et al. "Long-term Evaluation of Survival, Continence and Potency (SCP) Outcomes After Robot-assisted Radical Prostatectomy (RARP)." BJU International, vol. 112, no. 3, 2013, pp. 338-45.
Ficarra V, Borghesi M, Suardi N, et al. Long-term evaluation of survival, continence and potency (SCP) outcomes after robot-assisted radical prostatectomy (RARP). BJU Int. 2013;112(3):338-45.
Ficarra, V., Borghesi, M., Suardi, N., De Naeyer, G., Novara, G., Schatteman, P., De Groote, R., Carpentier, P., & Mottrie, A. (2013). Long-term evaluation of survival, continence and potency (SCP) outcomes after robot-assisted radical prostatectomy (RARP). BJU International, 112(3), 338-45. https://doi.org/10.1111/bju.12001
Ficarra V, et al. Long-term Evaluation of Survival, Continence and Potency (SCP) Outcomes After Robot-assisted Radical Prostatectomy (RARP). BJU Int. 2013;112(3):338-45. PubMed PMID: 23470027.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term evaluation of survival, continence and potency (SCP) outcomes after robot-assisted radical prostatectomy (RARP). AU - Ficarra,Vincenzo, AU - Borghesi,Marco, AU - Suardi,Nazareno, AU - De Naeyer,Geert, AU - Novara,Giacomo, AU - Schatteman,Peter, AU - De Groote,Ruben, AU - Carpentier,Paul, AU - Mottrie,Alexander, Y1 - 2013/03/07/ PY - 2013/3/9/entrez PY - 2013/3/9/pubmed PY - 2013/9/12/medline KW - erectile function KW - localised prostate cancer KW - oncological outcomes KW - robot-assisted radical prostatectomy KW - urinary continence SP - 338 EP - 45 JF - BJU international JO - BJU Int VL - 112 IS - 3 N2 - OBJECTIVE: To report combined oncological and functional outcome in a series of patients who underwent robot-assisted radical prostatectomy (RARP) for clinically localised prostate cancer in a single European centre after 5-year minimum follow-up according to survival, continence and potency (SCP) outcomes. PATIENTS AND METHODS: We extracted from our prostate cancer database all consecutive patients with a minimum follow-up of 5 years after RARP. Biochemical failure was defined as a confirmed PSA concentration of >0.2 ng/mL. All patients alive at the last follow-up were evaluated for functional outcomes using the Expanded Prostate Cancer Index Composite (EPIC) and Sexual Health Inventory for Men (SHIM) questionnaires. Oncological and functional outcomes were reported according to the SCP system. Specifically, patients were classified as using no pad (C0), using one pad for security (C1), and using ≥1 pad (C2) (not including the prior definition). Patients potent (SHIM score of >17) without any aids were classified as P0 category; patients potent (SHIM score of >17) with use of phosphodiesterase type 5 inhibitorsas P1; and patients with erectile dysfunction (SHIM score of <17) as P2 category. Patients who did not undergo a nerve-sparing technique, who were not potent preoperatively, who were not interested in erections, or who did not have sexual partners were classified as Px category. RESULTS: The 3-, 5- and 7-year biochemical recurrence-free survival rates were 96.3%; 89.6% and 88.3%, respectively. At follow-up, 146 (79.8%) were fully continent (C0), 20 (10.9%) still used a safety pad (C1) and 17 (9.3%) were incontinent using ≥1 pad (C2). Excluding Px patients, 52 patients (47.3%) were classified as P0; 41 patients (37.3%) were classified as P1 and 17 patients (15.5%) were P2. In patients preoperatively continent and potent, who received a nerve-sparing technique and did not require any adjuvant therapy, oncological and functional success was attained by 77 (80.2%) patients. In the subgroup of 67 patients not evaluable for potency recovery (Px), oncological and continence outcomes were attained in 46 patients (68.7%). CONCLUSIONS: Oncological and functional success was attained in a high percentage of patients who underwent RARP at ≥5 years follow-up. Interestingly, this study confirmed that excellent oncological and functional outcomes can be obtained in the 'best' category of patients, i.e. those preoperatively continent and potent and with tumour characteristics suitable for a nerve-sparing technique. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/23470027/Long_term_evaluation_of_survival_continence_and_potency__SCP__outcomes_after_robot_assisted_radical_prostatectomy__RARP__ L2 - https://doi.org/10.1111/bju.12001 DB - PRIME DP - Unbound Medicine ER -