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01-09-2021 | Prostate Cancer | Original Article

Urinary continence recovery and oncological outcomes after surgery for prostate cancer analysed by risk category: results from the LAParoscopic prostatectomy robot and open trial

Authors: Anna Hagman, Anna Lantz, Stefan Carlsson, Jonas Höijer, Johan Stranne, S. I. Tyritzis, Eva Haglind, Anders Bjartell, Jonas Hugosson, Olof Akre, Gunnar Steineck, Peter Wiklund

Published in: World Journal of Urology | Issue 9/2021

Abstract

Purpose

To evaluate urinary continence (UC) recovery and oncological outcomes in different risk-groups after robot-assisted radical prostatectomy (RALP) and open retropubic radical prostatectomy (RRP).

Patients and methods

We analysed 2650 men with prostate cancer from seven open (n = 805) and seven robotic (n = 1845) Swedish centres between 2008 and 2011 in a prospective non-randomised trial, LAPPRO. UC recovery was defined as change of pads less than once in 24 h. Information was collected through validated questionnaires. Rate of positive surgical margins (PSM) and biochemical recurrence (BCR), defined as prostate-specific antigen (PSA) > 0.25 mg/ml, were recorded. We stratified patients into two risk groups (low-intermediate and high risk) based on the D’Amico risk classification system.

Result

Among men with high-risk prostate cancer, we found significantly higher rates of UC recovery up to 24 months after RRP compared to RALP (66.1% vs 60.5%) RR 0.85 (CI 95% 0.73–0.99) while PSM was more frequent after RRP compared to RALP (46.8% vs 23.5%) RR 1.56 (CI 95% 1.10–2.21). In the same group no significant difference was seen in BCR. Overall, however, BCR was significantly more common after RRP compared to RALP at 24 months (9.8% vs 6.6%) RR 1.43 (Cl 95% 1.08–1.89). The limitations of this study are its non-randomized design and the relatively short time of follow-up.

Conclusions

Our study indicates that men with high-risk tumour operated with open surgery had better urinary continence recovery but with a higher risk of PSM than after robotic-assisted laparoscopic surgery. No significant difference was seen in biochemical recurrence.

Trial registration

ISRCTN06393679.

Available only for authorised users

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Title: Urinary continence recovery and oncological outcomes after surgery for prostate cancer analysed by risk category: results from the LAParoscopic prostatectomy robot and open trial
Authors: Anna Hagman
Anna Lantz
Stefan Carlsson
Jonas Höijer
Johan Stranne
S. I. Tyritzis
Eva Haglind
Anders Bjartell
Jonas Hugosson
Olof Akre
Gunnar Steineck
Peter Wiklund
Publication date: 01-09-2021
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Prostate Cancer
Urinary Incontinence
Prostatectomy
Urinary Incontinence
Prostatectomy
Published in: World Journal of Urology / Issue 9/2021
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-021-03662-0

At a glance: The STEP trials

Springer Medicine

Urinary continence recovery and oncological outcomes after surgery for prostate cancer analysed by risk category: results from the LAParoscopic prostatectomy robot and open trial

Abstract

Purpose

Patients and methods

Result

Conclusions

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Patients and methods

Result

Conclusions

Trial registration

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