Coman Radu-Tudor, Crisan Nicolae, Andras Iulia, Bud Gabriela, Matei Deliu-Victor, DE Cobelli Ottavio, Coman Ioan, Bocsan Ioan-Stelian
Epidemiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Urology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Clujul Med. 2018;91(1):92-97. doi: 10.15386/cjmed-825. Epub 2018 Jan 15.
To assess the outcomes of robotic radical prostatectomy in two different age subgroups of pre-operatively potent patients: younger than 50 years and older than 65 years.
We included in the present study a number of 202 patients with prostate cancer divided into two groups: 99 patients older than 65 years (group 1) and 103 patients younger than 50 years (group 2).
More than half of the younger patients were low-risk vs 57% of the older patients who were high-risk. Overall positive surgical margins rate was 21.2% in group 1 vs 12.1% in group 2. The early biochemical recurrence at 6 months after radical prostatectomy was 4% in group 1 vs 11.6% in group 2. The continence rate at 6 months was similar between the two groups and was not correlated with the patients' age (p=0.72), nerve-sparing (p=0.3 for group 1, p=0.92 for group 2) or pathological staging (overall p=0.81, p=0.89 in group 1 and p=0.63 in group 2). We observed a significantly higher rate of potency for patients in group 2 (91.5% vs 47.2%, p<0.0001). The most important factor associated with the regain of potency at 6 months after the procedure was the age of the patient (p<0.0001), independently of the type of nerve-sparing performed.
Age seems to be the most important predictor of the regain of potency after robotic radical prostatectomy. Patients should be counseled accordingly in order to have realistic expectations about the functional results after robotic-assisted surgery.
评估机器人根治性前列腺切除术在术前性功能正常的两个不同年龄亚组患者中的疗效：年龄小于50岁和年龄大于65岁。
本研究纳入了202例前列腺癌患者，分为两组：99例年龄大于65岁的患者（第1组）和103例年龄小于50岁的患者（第2组）。
超过一半的年轻患者为低风险，而老年患者中57%为高风险。第1组的总体手术切缘阳性率为21.2%，第2组为12.1%。根治性前列腺切除术后6个月的早期生化复发率，第1组为4%，第2组为11.6%。两组6个月时的控尿率相似，且与患者年龄（p=0.72）、保留神经（第1组p=0.3，第2组p=0.92）或病理分期（总体p=0.81，第1组p=0.89，第2组p=0.63）无关。我们观察到第2组患者的性功能恢复率显著更高（91.5%对47.2%，p<0.0001）。与术后6个月性功能恢复相关的最重要因素是患者年龄（p<0.0001），与所进行的保留神经类型无关。
年龄似乎是机器人根治性前列腺切除术后性功能恢复的最重要预测因素。应相应地向患者提供咨询，以便他们对机器人辅助手术后的功能结果有现实的期望。
