Feasibility of robot-assisted radical prostatectomy in men at senior age ≥75 years: perioperative, functional, and oncological outcomes of a high-volume center.
Sami-Ramzi Leyh-Bannurah, Christian Wagner, Andreas Schuette, Nikolaos Liakos, Theodoros Karagiotis, Mikolaj Mendrek, Pawel Rachubinski, Matthias Oelke, Zhe Tian, Jorn H Witt
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引用次数: 9
Abstract
Objectives: The aim of this study was to assess whether age ≥75 years impairs surgical, functional, and oncological outcomes after robot-assisted radical prostatectomy (RARP).
Materials and methods: Patients with prostate cancer (PCa) were stratified in ≥75(n = 669) vs. <70 years(n = 8,268). Multivariable cox regression analyses (MVA) tested for effect of senior age on erectile function-, urinary continence-recovery, biochemical recurrence (BCR), and metastatic progression (MP).
Results: RARP duration, blood loss, and 30d complication rates were similar between groups. For patients ≥75 vs. <70 years, rates of erectile function after 36 and urinary continence after 12 months were 27 vs. 56% (p < 0.001) and 85 vs. 86% (p = 0.99), respectively. Mean quality of life (QoL) score after 12 months improved in both groups (p = 0.9). At 48 months, BCR- and MP-free rates were 77 vs. 85% (p < 0.001) and 97 vs. 98% (p = 0.3), respectively. MVA confirmed the negative effect of senior age on erectile function but no significant effect on urinary continence, BCR or MP, before and after propensity score matching.
Conclusion: Apart from erectile function, senior age has no significant effect on urinary continence recovery, BCR- or MP-free rates after RARP. Post-RARP QoL improved even in senior patients. Modern therapy of senior PCa patients should be based on individual counseling than just age.
目的:本研究的目的是评估年龄≥75岁是否会影响机器人辅助根治性前列腺切除术(RARP)后的手术、功能和肿瘤预后。材料和方法:对≥75例前列腺癌(PCa)患者进行分层(n = 669 vs. n = 8268)。多变量cox回归分析(MVA)测试了老年对勃起功能、尿失禁恢复、生化复发(BCR)和转移进展(MP)的影响。结果:两组间RARP持续时间、出血量、30d并发症发生率相似。≥75例(p = 0.99)。两组患者12个月后平均生活质量(QoL)评分均有改善(p = 0.9)。48个月时，无BCR和无mp率分别为77%和85% (p p = 0.3)。倾向评分匹配前后，MVA证实高龄对勃起功能有负面影响，但对尿失禁、BCR或MP无显著影响。结论:除勃起功能外，年龄对RARP术后尿失禁恢复、BCR-或MP-free率无显著影响。即使是老年患者，rarp后的生活质量也有所改善。老年PCa患者的现代治疗应基于个体咨询，而不仅仅是年龄。
期刊介绍：
ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications.
The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.
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