Comparative evaluation of continence and potency after radical prostatectomy: Robotic vs. laparoscopic approaches, validating LAP-01 trial

IF 2.3 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford Pub Date : 2024-06-28 DOI:10.1016/j.suronc.2024.102098

Alicia López-Abad , Gerardo Server Gómez , Juan Pablo Loyola Maturana , Inés Giménez Andreu , Argimiro Collado Serra , Augusto Wong Gutiérrez , Juan Boronat Catalá , Pedro de Pablos Rodríguez , Álvaro Gómez-Ferrer , Juan Casanova Ramón-Borja , Miguel Ramírez Backhaus

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引用次数: 0

Abstract

Background

Minimally invasive techniques have demonstrated several advantages over the open approach. In the field of prostate cancer, the LAP-01 trial demonstrated the superiority of robotic-assisted radical prostatectomy (RARP) over laparoscopic radical prostatectomy (LRP) when comparing continence at 3-month after surgery, with no statistically significant differences at 6 and 12 months of follow-up.

Objectives

Externally validate the LAP-01 study and compare functional outcomes between the two minimally invasive approaches.

Material and methods

This retrospective study, conducted by a single surgeon (MRB), utilized data from a prospectively collected database, which included patients who underwent both RARP or LRP. Data regarding baseline characteristics, continence (assessed through the 24-h Pad test and ICIQ questionnaire) and potency were collected at multiple time points: 1 and 6 weeks after catheter removal, 3-, 6-, and 12-months post-surgery.

Results

The study encompasses 601 patients, 455 who underwent LRP and 146 RARP. The median age at diagnosis was 64 for LRP and 62 for RARP, while the median PSA levels at diagnosis were 6.7 ng/mL for LRP and 6.5 ng/mL for RARP. Bilateral nerve-sparing procedures were performed in 34.07 % of LRP cases and 51.37 % of RARP cases.

RARP exhibited a significant advantage over LRP both in continence and potency. Continence rates at 3-, 6- and 9-month after radical prostatectomy (RP) were 36.43 %, 61.86 % and 79.87 % for LRP, compared to 50.98 %, 69.87 % and 91.69 % for RARP. Potency rates at the same intervals were 0.90 %, 3.16 % and 6.39 % for LRP, and 6.19 %, 9.16 % and 18.96 % for RARP. These rates were more pronounced in patients with bilateral nerve-sparing.

Conclusion

Our study demonstrates that RARP results in significantly better continence recovery and superior potency outcomes throughout the entire follow-up period compared to LRP, even at the beginning of the robotic approach learning curve.

查看原文本刊更多论文

根治性前列腺切除术后尿失禁和排尿能力的比较评估：机器人与腹腔镜方法的比较，验证 LAP-01 试验。

背景：与开放式方法相比，微创技术具有多项优势。在前列腺癌领域，LAP-01 试验表明，与腹腔镜前列腺癌根治术（LRP）相比，机器人辅助前列腺癌根治术（RARP）在术后 3 个月的尿失禁情况方面更具优势，而在随访 6 个月和 12 个月时，两者的差异无统计学意义：外部验证 LAP-01 研究，比较两种微创方法的功能结果：这项回顾性研究由一名外科医生（MRB）进行，利用了前瞻性数据库中的数据，其中包括同时接受 RARP 或 LRP 的患者。在多个时间点收集了有关基线特征、尿失禁（通过 24 小时垫测试和 ICIQ 问卷进行评估）和排尿能力的数据：结果：这项研究包括 601 名患者，其中 455 人接受了 LRP，146 人接受了 RARP。LRP患者诊断时的中位年龄为64岁，RARP患者为62岁；LRP患者诊断时的中位PSA水平为6.7纳克/毫升，RARP患者为6.5纳克/毫升。34.07%的LRP病例和51.37%的RARP病例进行了双侧神经保留手术。与 LRP 相比，RARP 在通畅性和有效性方面都有明显优势。根治性前列腺切除术（RP）后3个月、6个月和9个月的尿失禁率，LRP分别为36.43%、61.86%和79.87%，而RARP分别为50.98%、69.87%和91.69%。在相同时间间隔内，LRP 的效力率分别为 0.90 %、3.16 % 和 6.39 %，RARP 的效力率分别为 6.19 %、9.16 % 和 18.96 %。这些比率在双侧神经保留的患者中更为明显：我们的研究表明，与 LRP 相比，RARP 在整个随访期间的尿失禁恢复情况明显更好，药效也更佳，即使在机器人方法学习曲线的初期也是如此。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Oncology-Oxford 医学-外科

CiteScore

4.50

自引率

0.00%

发文量

169

审稿时长

38 days

期刊介绍： Surgical Oncology is a peer reviewed journal publishing review articles that contribute to the advancement of knowledge in surgical oncology and related fields of interest. Articles represent a spectrum of current technology in oncology research as well as those concerning clinical trials, surgical technique, methods of investigation and patient evaluation. Surgical Oncology publishes comprehensive Reviews that examine individual topics in considerable detail, in addition to editorials and commentaries which focus on selected papers. The journal also publishes special issues which explore topics of interest to surgical oncologists in great detail - outlining recent advancements and providing readers with the most up to date information.