Impact of neurovascular bundle preservation on biochemical recurrence after robot-assisted radical prostatectomy for high-risk prostate cancer.

IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY
Hiroki Hagimoto, Masashi Kubota, Yoshiyuki Matsui, Takayuki Sumiyoshi, Ryoichi Saito, Takehiko Segawa, Shigeki Fukuzawa, Kenji Mitsumori, Toru Yoshida, Toshiya Akao, Yuya Sekine, Hiromitsu Negoro, Ryoma Kurahashi, Kimihiro Shimatani, Atsuro Sawada, Shusuke Akamatsu, Takashi Kobayashi, Takayuki Goto, The Daimonji Clinical Application Database Dai-Cad
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引用次数: 0

Abstract

Purpose: To evaluate functional and oncological outcomes in patients who underwent unilateral or bilateral nerve-sparing (NS) robot-assisted radical prostatectomy (RARP) for high-risk prostate cancer.

Methods: The cohort comprised 2683 patients with clinical stage T1-4, N0M0 high-risk prostate cancer who underwent RARP in Japanese tertiary care centers from August 2011 to April 2023. High risk was defined using the European Association of Urology risk stratification criteria. Patients were classified as high risk if they had clinical stage T2c-T4, a serum prostate-specific antigen concentration (PSA) of > 20 ng/dL, or an International Society of Urological Pathology (ISUP) grade of 4-5. Patients were grouped into NS and non-NS surgery groups. Propensity score matching was performed (1:1 ratio) to reduce confounding bias. The primary outcome was biochemical recurrence (BCR)-free survival (BCR-FS). The impact of NS surgery on BCR-FS was examined in the propensity score-matched cohort using Cox proportional hazards regression.

Results: The propensity score-matched cohort comprised 1722 patients. In the matched cohort, median follow-up was 31.9 months. The 5-year BCR-FS was 70.2% in the NS group and 71.9% in the non-NS group (HR 1.05; 95% confidence interval, 0.85-1.29). NS surgery did not increase the risk of BCR in subgroups of patients stratified according to ISUP grade, T stage, percent cancer core involvement, and PSA.

Conclusion: Neurovascular bundle preservation during RARP for high-risk prostate cancer appears feasible without increasing the BCR rate. However, the retrospective study design carries the potential influence of selection bias.

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来源期刊
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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