NARUS 2018: Patients with High Risk Prostate Cancer Demonstrate Significant Urinary Benefit after Radical Prostatectomy
For this study, the authors queried their prospectively maintained database of all men undergoing robotic prostatectomy for high-risk disease from January 1, 2013 to June 1, 2017 at a single institution. Demographic variables such as age, BMI, preoperative Gleason score, PSA, trans-rectal ultrasound volume and ASA status were included. Clinicopathologic variables such as Gleason score, positive surgical margins (PSM), EPE, seminal vesicle invasion, lympho-vascular invasion, lymph node positivity, postoperative PSA, and IPSS/SHIM scores at 3, 6, and 12 months postoperatively were examined.
There were 88 patients that underwent RALP for AUA high-risk prostate cancer with a mean age of 63.6 years and BMI of 29.9. Preoperatively, 13 patients (14.7%) took either alpha blocker or 5-alpha reductase inhibitor (or both) for LUTS. Postoperatively, over 70% of patients exhibited mild LUTS (0-7) with less than 5% complaining of severe LUTS (20-35). Of those patients who reported improvement in their voiding symptoms, the average decrease in IPSS was approximately 6 points. Moreover, for patients who had at least 1 year follow-up, 80% showed continued or similar improvement. Among the 13 patients that took an alpha blocker or 5-alpha reductase inhibitor, no patient took either medication postoperatively.
The authors concluded that patients undergoing radical prostatectomy for high-risk prostate cancer achieved a significant, durable benefit with respect to voiding symptoms.
Presented By: Ram A. Pathak, Wake Forest School of Medicine, Winston-Salem, NC
Co-Authors: Ashok K. Hemal
Written By: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre, @zklaassen_md ,at the 2018 North American Robotic Urology Symposium, February 16-17, 2018 - Las Vegas, NV