Koterazawa Shigeki, Kubota Masashi, Sumiyoshi Takayuki, Saito Ryoichi, Takaoka Naoto, Hattori Yuto, Shimizu Yosuke, Kanno Toru, Soda Takeshi, Okada Yoshiyuki, Tsuchihashi Kazunari, Sekine Yuya, Negoro Hiromitsu, Kurahashi Ryoma, Shimatani Kimihiro, Sawada Atsuro, Akamatsu Shusuke, Goto Takayuki, Kobayashi Takashi
Department of Urology, Kyoto University School of Medicine, 54 Shougoinkawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
Department of Urology, Ijinkai Takeda General Hospital, Kyoto, Japan.
Int J Clin Oncol. 2025 Feb;30(2):340-350. doi: 10.1007/s10147-024-02660-7. Epub 2024 Dec 2.
For prostate cancer (PCa) in the elderly, including patients ≥ 80 years, the safety of robot-assisted radical prostatectomy (RARP) is controversial. We aimed to evaluate the effect of aging on the postoperative complication rates after RARP.
This cohort study used a database of patients who had undergone RARP at 25 different institutes. We divided the cohort into four age groups (< 70, 70-74, 75-79, and ≥ 80 years). The complication rates after RARP in the 70-74, 75-79, and ≥ 80 year group were compared using the < 70 year group serving as the control group by applying the inverse probability of treatment weighting (IPTW)-adjusted regression analysis.
A total of 8055 patients were evaluated. The postoperative complication rates were 8.8%, 9.7%, 9.6%, and 10.0% in the < 70, 71-74, 75-79, and ≥ 80 age groups, respectively. In IPTW-adjusted analyses, the risk of overall complications (< 70 vs. 70-74 year group: OR = 1.09 [95% CI 0.92-1.29]; < 70 vs. 75-79 year group: OR = 1.09 [95% CI 0.88-1.37], and < 70 vs. ≥ 80 year group: OR = 2.21 [95% CI 0.92-5.32]) did not change with increasing age. There was no significant increase in risk for any complication category, such as bowel dysfunction, symptomatic lymphocele, or bacterial infection, between the < 70 and ≥ 80 age groups.
Our findings showed that, in appropriately selected patients, the risk of complications after RARP did not increase with age, even at 75 or 80 years.
对于老年前列腺癌（PCa）患者，包括年龄≥80岁的患者，机器人辅助根治性前列腺切除术（RARP）的安全性存在争议。我们旨在评估年龄对RARP术后并发症发生率的影响。
这项队列研究使用了25个不同机构接受RARP治疗的患者数据库。我们将队列分为四个年龄组（<70岁、70 - 74岁、75 - 79岁和≥80岁）。通过应用治疗权重逆概率（IPTW）调整回归分析，以<70岁组作为对照组，比较70 - 74岁、75 - 79岁和≥80岁组RARP术后的并发症发生率。
共评估了8055例患者。<70岁、71 - 74岁、75 - 79岁和≥80岁年龄组的术后并发症发生率分别为8.8%、9.7%、9.6%和10.0%。在IPTW调整分析中，总体并发症风险（<70岁与70 - 74岁组：OR = 1.09 [95% CI 0.92 - 1.29]；<70岁与75 - 七岁组：OR = 1.09 [95% CI 0.88 - 1.37]，<70岁与≥80岁组：OR = 2.21 [95% CI 0.92 - 5.32]）并未随年龄增长而改变。在<70岁和≥80岁年龄组之间，任何并发症类别（如肠道功能障碍、有症状的淋巴囊肿或细菌感染）的风险均未显著增加。
我们的研究结果表明，在适当选择的患者中，RARP术后的并发症风险不会随年龄增加，即使在75岁或80岁时也是如此。
