DI Pierro Giovanni Battista, Grande Pietro, Mordasini Livio, Danuser Hansjörg, Mattei Agostino
Department of Urology, Lucerne Cantonal Hospital, Lucerne, Switzerland Deptartment of Obstetrics and Gynecology Sciences and Urologic Sciences, 'Sapienza' University, Rome, Italy.
Deptartment of Obstetrics and Gynecology Sciences and Urologic Sciences, 'Sapienza' University, Rome, Italy.
Anticancer Res. 2016 Aug;36(8):4201-7.
To analyze safety and efficacy of robot-assisted radical prostatectomy (RARP) in a low-volume centre.
From 2008 to 2015, 400 consecutive patients undergoing RARP were prospectively enrolled. Complications were classified according to the Modified Clavien System. Biochemical recurrence (BCR) was defined as two consecutive prostate-specific antigen (PSA) values ≥0.2 ng/ml. Functional outcomess were assessed using validated, self-administered questionnaires.
Median patient age was 64.5 years. Mean standard deviation (SD) preoperative PSA level was 11.3 (11.7) ng/ml. Median interquartile range (IQR) follow-up was 36 (12-48) months. Overall complication rate was 27.7% (minor complications rate 16.2%). Overall 1-, 3- and 6-year BCR-free survival rates were 85.7%, 77.5% and 53.9%, respectively; these rates were 94.1%, 86.2% and 70.1% in pT2 diseases. At follow-up, 98.4% of patients were fully continent (median (IQR) time to continence was 2 (1-3) months) and 68.2% were potent (median (IQR) time to potency of 3 (3-4) months).
RARP appears to be a valuable option for treating clinically localised prostate cancer also in a low-volume institution.
分析在低容量中心开展机器人辅助根治性前列腺切除术（RARP）的安全性和有效性。
2008年至2015年，前瞻性纳入400例连续接受RARP的患者。并发症根据改良Clavien系统进行分类。生化复发（BCR）定义为连续两次前列腺特异性抗原（PSA）值≥0.2 ng/ml。使用经过验证的自我管理问卷评估功能结局。
患者中位年龄为64.5岁。术前PSA水平的平均标准差（SD）为11.3（11.7）ng/ml。随访的中位四分位间距（IQR）为36（12 - 48）个月。总体并发症发生率为27.7%（轻微并发症发生率为16.2%）。1年、3年和6年的总体无BCR生存率分别为85.7%、77.5%和53.9%；pT2期疾病的这些生存率分别为94.1%、86.2%和70.1%。随访时，98.4%的患者完全控尿（控尿的中位（IQR）时间为2（1 - 3）个月），68.2%的患者有性功能（性功能恢复的中位（IQR）时间为3（3 - 4）个月）。
对于治疗临床局限性前列腺癌，即使在低容量机构中，RARP似乎也是一种有价值的选择。
