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Minerva Urologica e Nefrologica 2018 February;70(1):66-73

DOI: 10.23736/S0393-2249.17.02909-5

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Outcomes following robotic-assisted laparoscopic prostatectomy: Pentafecta and Trifecta achievements

Seyed B. JAZAYERI, Brittany WEISSMAN, David B. SAMADI

Department of Urology, Lenox Hill Hospital, Hofstra Northwell School of Medicine, New York, NY, USA


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BACKGROUND: Functional and oncologic outcomes following radical prostatectomy play a major role in patient satisfaction after treatment. This study was designed to assess the functional and oncologic outcome after robotic assisted radical prostatectomy (RARP) in a single surgeon series of patients.
METHODS: A prospectively maintained database of patients undergoing robotic radical prostatectomy in a referral academic center was queried for functional and oncologic outcome. Patients undergoing RARP between 2010 and 2013 were included. Analysis was performed with SPSS and SAS, χ2, Mann-Whitney and t-test were used when appropriate.
RESULTS: Overall, 566 patients were included in the analysis. The Trifecta and Pentafecta was 73.9% and 64.1%, respectively. Patients achieving Pentafecta were younger (P<0.001), had lower PSA level (P=0.04), lower Biopsy Gleason (P<0.01), lower risk prostate cancer (P<0.01) and fewer comorbidities (P=0.03). The patients were followed up for a median of 27.4 months in Trifecta and 20.6 months in Pentafecta group. At 12-month follow-up the continence and potency rate was 90.6% and 84.1%, respectively.
CONCLUSIONS: Although preoperative counseling for RARP surgery using Pentafecta criteria offers more precise information and reasonable expectations than using the Trifecta, further research is required to prepare a standard reporting outline.


KEY WORDS: Prostatic neoplasms - Prostatectomy - Laparoscopic - Robotic surgical procedures - Urinary incontinence

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