Functional and perioperative outcomes in elderly men after robotic-assisted radical prostatectomy for prostate cancer.

We aimed to compare postoperative functional outcomes following robotic-assisted radical prostatectomy (RARP) in elderly men with localized prostate cancer.

A retrospective review of a prospectively maintained database of men who underwent RARP between January 2007 and November 2018 was performed. Patients over 65 years of age were selected (N = 302) and then stratified by age group: 66-69 years old (N = 214) and ≥ 70 years old (N = 88). Full continence was defined as strict 0-pad per day usage. Preoperative potency included those with a Sexual Health Inventory for Men score ≥ 17. Preoperative and postoperative functional outcomes were assessed. Kaplan-Meier analysis was used to estimate time to recovery of continence in both groups.

Both groups had comparable preoperative parameters. Continence rates at 1, 3, 6, 9, 12, 18 and 24 months in the 66-69-year-old group were 6%, 34%, 61%, 70%, 74%, 80% and 87%, respectively. Comparatively in the ≥ 70-year-old group, continence rates were significantly lower at all time points (3%, 22%, 50%, 56%, 66%, 69% and 75%, respectively). Men in the 66-69-year-old group were significantly more likely to be continent after RARP when compared to patients 70 years of age and above [(Hazards ratio (HR) 0.73; 95%confidence interval 0.54-0.97, (p = 0.035)].

Our results suggest that RARP is feasible in elderly patients. Nevertheless, elderly patients in the ≥ 70-year-old group had significantly inferior postoperative continence rates compared to patients aged 66-69 years. Such information is valuable when counselling men during preoperative RARP planning to ensure that they have realistic postoperative expectations.

World journal of urology. 2020 Feb 07 [Epub ahead of print]

Samer L Traboulsi, David-Dan Nguyen, Ahmed S Zakaria, Kyle W Law, Hanna Shahine, Malek Meskawi, Cristina Negrean, Pierre I Karakiewicz, Assaad El Hakim, Kevin C Zorn

Division of Urology, Department of Surgery, Centre hospitalier de l'université de Montréal (CHUM), Montreal, QC, Canada., Faculty of Medicine, McGill University, Montreal, QC, Canada., Division of Robotic Urology, Department of Surgery, Hôpital du Sacré Coeur de Montréal, Montreal, QC, Canada., Division of Urology, Department of Surgery, Centre hospitalier de l'université de Montréal (CHUM), Montreal, QC, Canada. .