Clinical and oncological outcomes of robot‑assisted radical prostatectomy with nerve sparing vs. non‑nerve sparing for high‑risk prostate cancer cases

  • Authors:
    • Kiyoshi Takahara
    • Makoto Sumitomo
    • Kosuke Fukaya
    • Takahito Jyoudai
    • Masashi Nishino
    • Masaru Hikichi
    • Kenji Zennami
    • Takuhisa Nukaya
    • Manabu Ichino
    • Naohiko Fukami
    • Hitomi Sasaki
    • Mamoru Kusaka
    • Ryoichi Shiroki
  • View Affiliations

  • Published online on: July 31, 2019     https://doi.org/10.3892/ol.2019.10692
  • Pages: 3896-3902
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Abstract

Robot‑assisted radical prostatectomy (RARP) is one of the most widely used procedures for localized prostate cancer (PCa). In the present study, the clinical and oncological outcomes of RARP with bilateral or unilateral nerve sparing (NS) for D'Amico high‑risk PCa cases were assessed. Among the 767 cases who received RARP at Fujita Health University Hospital between August 2009 and December 2016, 230 high‑risk PCa cases who were observed for >6 months comprised the retrospective study cohort. Bilateral NS was performed with the bilateral neurovascular bundle in eight, unilateral in 125 and none in 97 cases. Perioperative parameters [surgery time, console time, estimated blood loss, pathological stage, positive lymph node metastases [pN (+)], and surgical margin positivity] did not exhibit significant differences between the NS and non‑NS cohorts. During a median follow‑up time of 25 months, the 1‑ and 3‑year biochemical recurrence (BCR)‑free survival rates in the NS/non‑NS cohorts were 84.4/86.0 and 72.7/75.0%, respectively. There were no significant differences identified between the two groups at each time period. According to multivariate analysis, the resection margin was an important factor for time to BCR, regardless of the NS technique used. The numbers of pads used daily at 3 and 6 months after RARP between the NS/non‑NS cohorts were 1.1/1.5 and 0.6/1.0, respectively (P=0.045 and P=0.009), suggesting that the NS technique resulted in significantly improved outcomes regarding urinary continence recovery. In selected high‑risk PCa cases, the NS technique resulted in equivalent oncological outcomes and improved urinary continence compared with the non‑NS RARP group.

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October 2019
Volume 18 Issue 4

Print ISSN: 1792-1074
Online ISSN:1792-1082

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APA
Takahara, K., Sumitomo, M., Fukaya, K., Jyoudai, T., Nishino, M., Hikichi, M. ... Shiroki, R. (2019). Clinical and oncological outcomes of robot‑assisted radical prostatectomy with nerve sparing vs. non‑nerve sparing for high‑risk prostate cancer cases. Oncology Letters, 18, 3896-3902. https://doi.org/10.3892/ol.2019.10692
MLA
Takahara, K., Sumitomo, M., Fukaya, K., Jyoudai, T., Nishino, M., Hikichi, M., Zennami, K., Nukaya, T., Ichino, M., Fukami, N., Sasaki, H., Kusaka, M., Shiroki, R."Clinical and oncological outcomes of robot‑assisted radical prostatectomy with nerve sparing vs. non‑nerve sparing for high‑risk prostate cancer cases". Oncology Letters 18.4 (2019): 3896-3902.
Chicago
Takahara, K., Sumitomo, M., Fukaya, K., Jyoudai, T., Nishino, M., Hikichi, M., Zennami, K., Nukaya, T., Ichino, M., Fukami, N., Sasaki, H., Kusaka, M., Shiroki, R."Clinical and oncological outcomes of robot‑assisted radical prostatectomy with nerve sparing vs. non‑nerve sparing for high‑risk prostate cancer cases". Oncology Letters 18, no. 4 (2019): 3896-3902. https://doi.org/10.3892/ol.2019.10692