Robot-Assisted Radical Prostatectomy for Potential Cancer Control in Patients with Metastatic Prostate Cancer |
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Authors: | Kimiaki Takagi Makoto Kawase Daiki Kato Kota Kawase Manabu Takai Koji Iinuma Keita Nakane Noriyasu Hagiwara Toru Yamada Masayuki Tomioka Takuya Koie |
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Institution: | 1.Department of Urology, Daiyukai Daiichi Hospital, Ichinomiya 4918551, Japan;2.Department of Urology, Graduate School of Medicine, Gifu University, Gifu 5011194, Japan; (M.K.); (D.K.); (K.K.); (M.T.); (K.I.); (K.N.);3.Department of Urology, Matsunami General Hospital, Gifu 5016062, Japan;4.Department of Urology, Tokai Central Hospital, Kakamigahara 5048601, Japan;5.Department of Urology, Japanese Red Cross Takayama Hospital, Takayama 5068550, Japan; |
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Abstract: | Recently, cytoreductive prostatectomy for metastatic prostate cancer (mPCa) has been associated with improved oncological outcomes. This study was aimed at evaluating whether robot-assisted radical prostatectomy (RARP) as a form of cytoreductive prostatectomy can improve oncological outcomes in patients with mPCa. We conducted a retrospective study of twelve patients with mPCa who had undergone neoadjuvant therapy followed by RARP. The endpoints were biochemical recurrence-free survival, treatment-free survival, and de novo metastasis-free survival. At the end of the follow-up period, none of the enrolled patients had died from PCa. The 1- and 2-year biochemical recurrence-free survival rates were 83.3% and 66.7%, respectively, and treatment-free survival rates were 75.0% and 56.3%, respectively. One patient developed de novo bone metastases 6.4 months postoperatively, and castration-resistant prostate cancer 8.9 months postoperatively. After RARP, the median duration of recovery of urinary continence was 5.2 months. One patient had severe incontinence (>2 pads/day) 24 months postoperatively. RARP may be a treatment option in patients with mPCa who have achieved a serum prostate-specific antigen level < 0.2 ng/mL, and present without new lesions on imaging. |
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Keywords: | robot-assisted radical prostatectomy metastatic prostate cancer neoadjuvant therapy treatment-free survival biochemical recurrence |
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