Robot assisted radical prostatectomy in elderly patients older than 70 years old: Operative, oncologic and functional outcomes

Abstract

INTRODUCTION: The aim of this study was to compare the results of patients who underwent robot-assisted radical prostatectomy (RARP) over 70 years old and those who underwent RARP under 70 years old. METHODS: A total of 1019 cases performed by 4 surgeons between February 2009 and December 2018 were reviewed retrospectively. First 50 cases of each surgeon were not included to exclude the learning curve effect. All patients (n = 819) were divided into two groups according patient age, Group 1 = ≥70 years old (n = 151), Group 2 = <70 years old (n = 668). RESULTS: : Mean patient age was 72.6+- 2.5 versus 60.9+-5.4 years p=0.00; mean console time was 148.2+-53.3 versus 148.7+-45.1 minutes, p=0.94; bladder neck reconstruction was 21.2% versus 12.4%, p=0.005; transurethral catheter removal time was 9.4+-3.4 versus 9.0+-3.9 days, p=0.170; for groups 1 and 2, respectively. Positive surgical margin rates were 27.2% versus 24.1%, p=0.432; erectile function (IIEF≥21) rates on postoperative 12th-month were 26.3% versus 50.2%, p=0.005 for groups 1 and 2, respectively. 12th-month continence rates were 89.5% versus 96.6%, p=0.002 for groups 1 and group 2, respectively. DISCUSSION AND CONCLUSION: RARP in patients over 70 years old is worse in terms of functional outcomes than patients under 70 years old. RARP surgery in patients over 70 years old is a safe surgical procedure with similar oncologic and operative outcomes.

Keywords

• prostate cancer
• robotic prostatectomy
• elderly patients