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Robot-assisted radical prostatectomy in indian men of age 75 years and above: a propensity score-matched analysis

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Abstract

Older men undergoing robot-assisted radical prostatectomy (RARP) have been thought to have worse perioperative, functional and oncological outcomes than younger men. However, there is a dearth of matched studies on this subject in the currently available literature. Our study is a matched pair analysis of perioperative, oncological and functional outcomes of RARP in men < 75 years of age versus ≥ 75 years (62 in each group). There was no statistically significant difference in complications, length of stay, pathological stage, positive surgical margins (PSM) and nodal involvement. Older men were less likely to undergo nerve sparing in our study (8.0 vs 75.8% p = 0.01). Potency rates were too low to be compared. The 1-year continence rates, time to continence and the proportion of men with biochemical recurrence (BCR) were similar between the groups. Men ≥ 75 years developed BCR much earlier than < 75 years (30 versus 78 months p = 0.07). However, this was not statistically significant. Age ≥ 75 years was associated with a statistically insignificant 53.5% rise in the risk of BCR. It was also not associated with any increased risk of postoperative complications or PSM. RARP is a safe procedure in senior adults. The oncological and functional outcomes of RARP in senior adults are similar to younger men.

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Funding

No funding was received for conducting the study.

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Authors and Affiliations

  1. Division of Uro-Oncology, Max Institute of Cancer Care, Saket, New Delhi, India

    Danny Darlington Carbin, Puneet Ahluwalia & Gagan Gautam

  2. Division of Uro-Oncology and Robotic Surgery, Apollo Hospitals, Mumbai, India

    Ashwin Sunil Tamhankar

Authors
  1. Danny Darlington Carbin
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  2. Ashwin Sunil Tamhankar
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  3. Puneet Ahluwalia
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  4. Gagan Gautam
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Danny Darlington Carbin, Ashwin Sunil Tamhankar, Puneet Ahluwalia and Gagan Gautam. The first draft of the manuscript was written by Danny Darlington Carbin and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Gagan Gautam.

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All the authors declare that they have no conflict of interest.

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Ethical approval was waived by the local ethics committee in view of the retrospective nature of the study, and all the procedures being performed were part of the routine care.

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Carbin, D.D., Tamhankar, A.S., Ahluwalia, P. et al. Robot-assisted radical prostatectomy in indian men of age 75 years and above: a propensity score-matched analysis. J Robotic Surg 16, 799–806 (2022). https://doi.org/10.1007/s11701-021-01301-9

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  • DOI: https://doi.org/10.1007/s11701-021-01301-9

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