To evaluate factors (clinical, pathological and perioperative) associated with the risk of hospital readmission after radical prostatectomy (RP) over the long term in a single tertiary referral center where both open RP (ORP) and robot assisted RP (RARP) are performed.
From December 2013 to December 2018 patients older than 18 years, who provided signed consent and underwent open or robot assisted radical prostatectomy were enrolled and retrospectively evaluated. Patients who underwent any previous prostate cancer (PCA) treatments were excluded. Specifically, skilled and experienced surgeons performed the two surgical approaches. Patients were followed for complications and hospital readmission (RAD) for a period of six months. The association of factors with the risk of readmission was assessed by Cox's multivariate proportional hazards.
1062 patients underwent RP. RARP was performed in 891 cases and ORP in 171 subjects. Extended pelvic lymph node dissection (ePLND) was performed in 651 patients. Hospital readmission occurred in 53 cases (5%). Based on the final multivariate model, independent factors associated with the risk of hospital readmission were seminal vesicle invasion (hazard ratio, HR = 2,093; 95%CI: 1,177-3,722), ORP (HR =4,393; 95%CI: 2,516-7,672) and ePLND (HR = 4,418; 95%CI: 1,544-12,639).
ORP, ePLND and seminal vesicle invasion are independent predictors of the risk of hospital readmission over the long term at a large single tertiary referral center. When surgery is chosen as a primary treatment of PCA, patients should be informed of the risk of hospital readmission and related risk factors. Assessing seminal vesicle invasion by preoperative clinical staging identifies locally advanced disease, which is associated with an increased risk of hospital readmission.
Minerva urologica e nefrologica = The Italian journal of urology and nephrology. 2019 Dec 12 [Epub ahead of print]
Marco Sebben, Alessandro Tafuri, Marco Pirozzi, Tania Processali, Riccardo Rizzetto, Nelia Amigoni, Aliasger Shakir, Mario De Michele, Andrea Panunzio, Clara Cerrato, Leone Tiso, Giovanni Novella, Matteo Brunelli, Filippo Migliorini, Vincenzo De Marco, Salvatore Siracusano, Walter Artibani, Antonio B Porcaro
Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy., USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California (USC), Los Angeles, CA, USA., Department of Pathology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy., Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy - .