MP52-19 AGE STRATIFIED PROPENSITY SCORE MATCHED STUDY OUTCOMES OF ROBOTIC ASSISTED RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Basic Research V1 Apr 2014MP52-19 AGE STRATIFIED PROPENSITY SCORE MATCHED STUDY OUTCOMES OF ROBOTIC ASSISTED RADICAL PROSTATECTOMY Srinivas Samavedi, Haidar Abdul-Muhsin, Suneel Pigilam, Kenneth Palmer, George Ebra, Ananthakrishnan Sivaraman, Vipul Patel, and Rafael Coelho Srinivas SamavediSrinivas Samavedi More articles by this author , Haidar Abdul-MuhsinHaidar Abdul-Muhsin More articles by this author , Suneel PigilamSuneel Pigilam More articles by this author , Kenneth PalmerKenneth Palmer More articles by this author , George EbraGeorge Ebra More articles by this author , Ananthakrishnan SivaramanAnanthakrishnan Sivaraman More articles by this author , Vipul PatelVipul Patel More articles by this author , and Rafael CoelhoRafael Coelho More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1629AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Elderly patients have the potential of increased morbidity from prostate surgery. Our goal was to evaluate the perioperative and short term oncological outcomes of RARP in patients above 70 years. Methods The study population (N=3241) consisted of consecutive patients who underwent RARP for localized prostate cancer by a single surgeon (VP) from January 2008 through February 2012. Patients who received prior radiation, focal therapy for prostate cancer, androgen deprivation therapy or classified as salvage were excluded from the study. A query of our Institutional Review Board approved registry identified 400 men 70 years of age and over who were computer-matched in a 1:1 ratio to younger patients using an optimal matching algorithm. Perioperative and postoperative functional and oncologic outcomes for the two groups were compared Results The study groups demonstrated no significant differences in preoperative clinical characteristics except age. The mean operative time was significantly less for younger patients 75.9 min vs 78.9 min (p<0.005). The estimated blood loss and transfusion rate was similar. Full nerve sparing as well as the ease of nerve sparing were also similar. Intraoperative complications were comparable. Postoperative pathological examination were equivalent in the occurrence of positive surgical margins, pathological stage T, Gleason sum score, seminal vesicle invasion, extracapsular extension, tumor volume and dimension. Prostate weight was higher for elderly patients 62.5 g vs 54.3 g (p<0.001). Postoperative complication occurrence rates were similar (93.3% vs 93.5%). Pain scores, hospital length of stay and indwelling catheter days were comparable. At follow-up, younger patients had a continence rate of 94.1% vs older patients 90.4%. average time to continence was similar (3.0 months in younger men vs 3.2 months in older men) and for potency 6.5 months for younger patients vs. 5.7 months for older patients. A greater proportion of younger patients became potent than elderly (p<0.001). At 60 months, freedom from biochemical recurrence(BCR) ± standard error of the mean for younger patients was 89.4% ± 2.1 (17 patients at risk) and 89.4% ± 2.1 (20 patients at risk) for the older group. The mean time to BCR for younger patients (n=33) was 14.5 months ± 12.3 and 18.7 months ± 13.5 for older patients (n=31) Conclusions Patients above 70 years of age have no increased perioperative morbidity inferior oncological outcomes compared to younger patients. In appropriately selected patients prostatectomy is a resonable option © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e587 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Srinivas Samavedi More articles by this author Haidar Abdul-Muhsin More articles by this author Suneel Pigilam More articles by this author Kenneth Palmer More articles by this author George Ebra More articles by this author Ananthakrishnan Sivaraman More articles by this author Vipul Patel More articles by this author Rafael Coelho More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...