Journal List > Korean J Urol > v.49(4) > 1005089

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Ham, Park, Rha, and Choi: Outcomes of Robotic Prostatectomy for Treating Clinically Advanced Prostate Cancer
Original Article
Korean Journal of Urology

Korean Journal of Urology 2008; 49(4): 325-329.

Published online: 30 April 2008

DOI: https://doi.org/10.4111/kju.2008.49.4.325

Outcomes of Robotic Prostatectomy for Treating Clinically Advanced Prostate Cancer

Won Sik Ham, Sung Yul Park, Koon Ho Rha, Young Deuk Choi

Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

youngd74@yuhs.ac

Received 3 January 2008       Accepted 19 February 2008

Copyright © 2008 The Korean Urological Association

Abstract

Purpose

Robotic prostatectomy (RP) has been widely performed for treating clinically localized prostate cancer (PC), whereas for treating clinically advanced PC, prostatectomy is usually done by open methods. We evaluated the outcomes of RP for treating patients with clinically advanced PC as compared with the outcomes of RP for treating patients with clinically localized PC.

Materials and Methods

We performed RP in 273 patients with the da Vinci® robot system through a transperitoneal approach. Ninety-two patients had clinically advanced PC (Group I) and 181 patients had clinically localized PC (Group II). We compared the perioperative variables and early surgical outcomes between the two groups.

Results

The two groups did not show significant differences for their mean age, but the mean preoperative prostate-specific antigen (PSA) levels and biopsy Gleason scores were significantly higher in Group I. There were no significant differences in the mean operation time (Group I: 214.9±45.1 min, II: 217.8±49.0 min, p=0.709), the estimated blood loss (Group I: 382.8±281.5ml, II: 387.5±369.5ml, p=0.934), the duration of bladder catheterization (Group I: 12.0±2.8 days, II: 12.9±4.6 days, p=0.232), the hospital stay (Group I: 5.9±3.5 days, II: 5.0±2.4 days, p=0.154), and the time to start the postoperative regular diet (Group I: 2.5±1.5 days, II: 2.0±0.6 days, p=0.089) between the two groups. There was a significant difference in lymph node invasion (p<0.001), but no difference in the positive surgical margin (p=0.180). Two out of the 4 intraoperative rectal injuries occurred in the clinically advanced PC group, but they were closed primarily without specific problems, except for 1 case.

Conclusions

Our results suggest that RP may be performed safely for patients with clinically advanced PC.

Keywords: Prostatic neoplasms, Open radical prostatectomy, Robotic radical prostatectomy

Figures and Tables

Table 1
Preoperative RP patient characteristics
kju-49-325-i001

BMI: body mass index, NHT: neoadjuvant hormonal therapy, PSA: prostate-specific antigen, RP: robotic radical prostatectomy

Table 2
Intraoperative and perioperative parameters according to the clinical stage
kju-49-325-i002

*Mean±SD, ECE: extracapsular extension, EBL: estimated blood loss, LN: lymph node

Table 3
Analysis of the factors predicting a positive surgical margin in the RP patients
kju-49-325-i003

RP: robotic radical prostatectomy, PSA: prostate-specific antigen, CI: confidence interval, LN: lymph node, ECE: extracapsular extension, NHT: neoadjuvant hormonal therapy

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