Introduction to Radical Prostate

PATIENTS AND METHOD Ambispective, multicenter study of 1955 patients with localized prostate cancer undergoing radical prostatectomy between 2005 and 2018.

BACKGROUND Long-term survival can be achieved in patients affected by localized prostate cancer (PCa) treated with either radical prostatectomy (RP) or external beam radiotherapy (EBRT).

Objective To assess the impact of focality and location of positive surgical margins (PSM) on long‐term outcomes after radical prostatectomy (RP) for prostate cancer (PCa), including biochemical recurrence (BCR), metastasis and overall mortality.

INTRODUCTION AND OBJECTIVES: The impact of a positive surgical margin (PSM) considering the nerve-sparing status on clinical outcomes in patients with prostate cancer treated with radical prostatectomy (RP) is largely unknown.

When initially robot-assisted laparoscopic surgery was introduced in urologic field, the focus was on radical prostatectomy and partial nephrectomy.

Periurethral suspension stitch during robot-assisted laparoscopic radical prostatectomy: description of the technique and continence outcomes.

A significant proportion of men with rising prostate-specific antigen (PSA) levels after radical prostatectomy (RP) fail prostate fossa (PF) salvage radiation treatment (SRT).

Background: To evaluate the efficacy of early dutasteride administration in patients with a detectable prostate-specific antigen (PSA) levels after robot-assisted radical prostatectomy (RARP).

He went on to receive an open radical prostatectomy and pelvic lymph node dissection as a curative treatment for his locally advanced disease.

We conducted a review of the literature to identify the clinical benefits of pelvic lymph node dissection (PLND) during radical prostatectomy for clinically localized prostate cancer.

The prostate testing for cancer and treatment (ProtecT) trial demonstrated no difference in survival for patients with primarily low/intermediate risk PCa randomized to active surveillance (AS), external beam radiotherapy (RT), or radical prostatectomy (RP).

Sixty-two patients received external beam radiotherapy, 34 underwent radical prostatectomy (RP), and 20 patients were on androgen deprivation therapy.

BACKGROUND Patients with advanced high-risk prostate cancer (PCa) are prone to have worse pathological diagnoses of positive surgical margins and/or lymph node invasion, resulting in early biochemical recurrence (BCR) despite having undergone radical prostatectomy (RP).

INTRODUCTION AND OBJECTIVES: The NEAR trial is a phase II single arm study of neoadjuvant apalutamide (ARN-509) and radical prostatectomy (RP) in the treatment of D’Amico intermediate and high-risk prostate cancer (Clinicaltrials.

Methods: This study included 155 patients with prostate cancer who underwent multiparametric magnetic resonance imaging prior to prostate biopsy (127 patients) or radical prostatectomy (28 patients) between January 2015 and June 2017; 159 foci of prostate cancer were included in our study.

PurposeTo evaluate focal therapy (hemiablation) eligibility in men undergoing prostate biopsy and multiparametric magnetic resonance imaging (mpMRI) with reference to histopathology from radical prostatectomy (RP) specimens.

BACKGROUND We conducted a comparative survival analysis between primary androgen deprivation therapy (PADT) and radical prostatectomy (RP) based on nationwide Korean population data that included all patients with prostate cancer.

Despite clinical and research experience with androgen deprivation therapy, and the popularity of prostatic brachytherapy and nerve-sparing radical prostatectomy, he remained an advocate for active surveillance and watchful waiting.

67Background: To compare 10 year treatment complication outcomes of radical prostatectomy(RP) vs external beam radiation therapy(EBRT) vs brachytherapy(BT) for patients with intermediate risk prost.

We compared overall survival between patients treated with radical prostatectomy (RP), external beam radiation therapy (EBRT), brachytherapy, and EBRT plus brachytherapy (EBRT+BT) using Cox proportional hazards models and propensity score matching.

INTRODUCTION AND OBJECTIVES: In recent years, several studies have shown the effectiveness and safety of the AdVance sling (Boston Scientific, formerly American Medical Systems) for treating male stress urinary incontinence (SUI) after radical prostatectomy.

Radical prostatectomy may cause stress urinary incontinence (SUI).

Methods We included consecutive patients who had extended pelvic lymph-node dissection associated with radical prostatectomy for IRPC.

As consequence, current guidelines include radical prostatectomy (RP) with extended pelvic lymph node dissection as a part of a multi-modal therapy for cN+ PCa patients (2).

METHODS: A retrospective analysis of a consecutive series of men who underwent robotic-assisted laparoscopic radical prostatectomy (RALRP) at our institution between 2004 and 2018 was conducted.

Background This study aims to compare the perioperative and pathological outcomes of open radical prostatectomy (ORP), laparoscopic radical prostatectomy (LRP), and robotic-assisted laparoscopic radical prostatectomy (RALRP) at Ramathibodi Hospital within Mahidol University in Thailand.

INTRODUCTION AND OBJECTIVES: Lymph node dissection (LND) during radical prostatectomy (RP) for prostate cancer (PCa) aims to provide information for staging and prognosis, while oncological and survival benefits are debatable.

Radical prostatectomy surgery is a therapeutic option that must be performed with extensive lymph node dissection and is often part of a multimodal care sequence.

Radical prostatectomy is frequently performed as a curative approach for clinically localized prostate cancer.

To estimate the conditional biochemical recurrence‐free probability and to develop a predictive model according to the disease‐free interval for men with clinically localized prostate cancer treated with minimally invasive radical prostatectomy.

We explored the feasibility of lifestyle interventions following radical prostatectomy for localised prostate cancer.

110 rostate cancer is the most common cancer among men in developed countries and radical prostatectomy is the cornerstone treatment for localised prostate cancer.

PurposeTo assess whole-body magnetic resonance imaging (wb-MRI) for detection of biochemical recurrence in comparison to 68Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (68Ga-PSMA PET/CT) in prostate cancer (Pca) patients after radical prostatectomy.

MATERIALS AND METHODS From our institutional database we identified 509 patients who underwent radical prostatectomy with preoperative magnetic resonance imaging and a postoperative Decipher® prostate cancer test.

BackgroundRetzius-sparing robot-assisted laparoscopic radical prostatectomy (rsRARP) allows entire prostatectomy procedure via the pouch of Douglas.

PURPOSE We aimed to compare the early continence recovery after surgical treatment of prostate cancer between Retzius-sparing robot-assisted radical prostatectomy and conventional robot-assisted radical prostatectomy.

We studied intraoperative factors through visualisation using a video editor of 148 patients who underwent robot-assisted radical prostatectomy, together with other perioperative factors associated with continence, and described in the literature.

In this study, 579 prostate cancer patients who underwent robot-assisted radical prostatectomy and 579 healthy controls were included.

INTRODUCTION AND OBJECTIVES: Urinary incontinence is an uncommon but devastating complication following robotic assisted laparoscopic radical prostatectomy (RALP).

INTRODUCTION AND OBJECTIVES: The average length of stay following robotic-assisted radical prostatectomy (RARP) is 24-48hrs and potentially longer on average in community settings.

Increasingly, studies have explored health-related quality-of-life (HRQOL) outcomes after robot-assisted radical prostatectomy (RARP).

BackgroundThe purpose of this study is to describe Health-Related Quality of Life (HRQoL) of localized prostate cancer patients in an Active Surveillance (AS) program, and to compare them with those undergoing radical prostatectomy (RP), external-beam radiotherapy (XRT) and brachytherapy (BT).

Participants (n=95) undergoing radical prostatectomy were assessed to determine the relationship between incontinence and pelvic floor muscle function, as seen on ultrasound.

The efficacy of perioperative pelvic floor muscle training (PFMT) for continence recovery after robot‐assisted radical prostatectomy (RARP) remains unclear.

INTRODUCTION AND OBJECTIVES: Salvage radiation therapy (SRT) represents a potential curative treatment option for prostate cancer (PCa) patients with rising PSA after radical prostatectomy (RP).

The need for adjuvant or salvage radiation therapy after radical prostatectomy worsens outcomes of both endourologic and formal repairs.

We report a case of a 43-year-old man who underwent a radical prostatectomy 3 years before the procedure (June 2015) for a locally advanced Gleason 7(4 + 3) prostate adenocarcinoma (pT3aN0), with negative surgical margins, followed by salvage radiotherapy.

PET/CT studies using Ga-PSMA-11 PET/CT and F-PSMA-1007 of a 61-year-old man after radical prostatectomy are presented.

To investigate the effects of lung protective ventilation (LPV) compared to conventional ventilation (CV) on postoperative respiratory parameters in patients undergoing robot-assisted radical prostatectomy (RARP).

Methods: A total of 200 consecutive patients undergoing Robot-assisted radical prostatectomy by a single surgeon were prospectively evaluated using either the valveless trocar (n = 100) or standard trocars (n = 100).

GPS has previously been validated as a predictor of adverse pathology in men with low-risk prostate cancer who undergo primary radical prostatectomy (RP).

We retrospectively analyzed the clinical and pathological data of individuals with very low-risk prostate cancer, according to the NCCN guidelines, who underwent mpMRI before radical prostatectomy at our institution between 2010 and 2016.

Data of CTCs from 65 treatment-naïve patients with biopsy-confirmed D’Amico-defined intermediate risk prostate cancer were compared to radical prostatectomy pathology results, which provided a clinical endpoint to the study and confirmed pre-operative pathology or demonstrated upgrading.

METHODS: Patients with AUA defined high-risk or unfavorable intermediate-risk prostate cancer and clinically localized disease on CT and/or MRI and bone scan already scheduled for robot assisted radical prostatectomy with extended pelvic lymph node dissection (RARP-EPLND) were eligible for this IRB-approved trial.

To assess whether atherosclerosis is involved in the development of overactive bladder and the function of lower urinary tract after robot‐assisted radical prostatectomy.

To assess changes in lower urinary tract symptoms (LUTS) and quality of life (QoL) after robot‐assisted radical prostatectomy (RARP).

PATIENT SUMMARY Prostate-specific membrane antigen radioguided surgery delays disease progression in selected patients with recurrent prostate cancer after radical prostatectomy.

OBJECTIVE To compare the accuracy of 68 Gallium prostate-specific membrane antigen positron emission tomography/computed tomography (68 Ga-PSMA PET/CT) with mpMRI in detecting and localising primary prostate cancer when compared with radical prostatectomy (RP) pathology.

BACKGROUND Prediction of lymph node invasion (LNI) after radical prostatectomy has been rarely assessed in robotically assisted laparoscopic radical prostatectomy (RALP) series.

BACKGROUND To investigate the risk factors contributing to multiple lymph node invasion (LNI) in patients with prostate cancer (PCa) undergoing extended pelvic lymph node dissection (ePLND) during robot assisted radical prostatectomy (RARP).

In this phase II trial, we evaluate neoadjuvant enzalutamide and leuprolide (EL) with or without abiraterone and prednisone (ELAP) before radical prostatectomy (RP) in men with locally advanced prostate cancer.

BACKGROUND Robot-assisted radical prostatectomy (RALP) in high-risk and locally advanced prostate cancer (PCa) is gaining increasing traction.

We aim to assess the outcomes of redoing FT (s-FT) after FT failure as an alternative to radical salvage procedures METHODS: From 2010 to 2018, 37 patients underwent s-FT and 28 patients salvage robotic radical prostatectomy (s-RRP) after focal high-intensity focused ultrasound, cryotherapy or vascular targeted photodynamic therapy.

Between May 2009 and December 2014, ZSI 375 was fitted in 109 SUI patients following radical prostatectomy, transurethral resection of prostate (TURP), rectal surgery and high intensity focused ultrasound (HIFU).

Case presentationA 67-year-old male patient underwent radical prostatectomy with ilio-obturator lymphonodectomy in 2016 due to poorly differentiated ductal adenocarcinoma (Gleason 4 + 5(40%) = 9) pT3bN0.

We present the case of a 72-year-old male patient who underwent radical prostatectomy due to an adenocarcinoma of the prostate gland (pT2c pN0 cM0 R0, Gleason Score: 3 + 3 = 6).

The aim of the present study was to construct a novel classification based on perioperative changes of membranous urethral length (MUL) using hierarchical cluster analysis to predict urinary incontinence (UI) and overactive bladder (OAB) symptoms after robot‐assisted radical prostatectomy (RARP).

INTRODUCTION AND OBJECTIVES: Multiple studies have demonstrated that a shorter membranous urethral length (MUL) is associated with a higher risk of incontinence post radical prostatectomy (RP).

A total of nine patients were treated (3 robot-assisted radical prostatectomies, 3 transperitoneal robot-assisted partial nephrectomies, 1 simple cystectomy with intracorporeal ileal conduit urinary diversion, 2 ureteral reimplantations).

RESULTS: A total of 15 patients were treated (5 robot-assisted radical prostatectomies, 3 transperitoneal robot-assisted partial nephrectomies, 3 cystectomies with intracorporeal ileal conduit urinary diversion, 3 ureteral reimplantations and 1 pyeloplasty).

To compare the outcomes of radical prostatectomy (RP), intensity-modulated radiation therapy (IMRT), and low-dose-rate brachytherapy (BT) using propensity score matching analysis in patients with clinically localized prostate cancer.

PURPOSE Long-term outcomes reveal equivalent biochemical outcomes with low-dose-rate (LDR) brachytherapy (BT) compared with radical prostatectomy and external-beam radiotherapy for the management of prostate cancer.

Previous studies have observed low rates of adjuvant radiotherapy after radical prostatectomy (RP) for high‐risk prostate cancer patients.

To analyse the perioperative and oncological outcomes of all radical prostatectomies (RPs) performed for high‐risk prostate cancer in the British Association of Urological Surgeons (BAUS) national registry from 2014 to 2015.

MethodsThis study was a pre-planned secondary analysis of a larger randomized controlled trial of home-based exercise prehabilitation versus control for men undergoing radical prostatectomy.

METHODS This pilot randomized controlled trial (RCT) recruited men who were beginning a standard care (SC) structured penile rehabilitation program following radical prostatectomy.

Our aim is to evaluate the association between body mass index (BMI) and preoperative total testosterone (TT) levels with the risk of single and multiple metastatic lymph node invasion (LNI) in prostate cancer patients undergoing radical prostatectomy and extended pelvic lymph node dissection.

The effects of age, diabetes type, diabetes related complications, body mass index, Charlson Comorbidity Index (CCI), history of immunosuppression, previous radical prostatectomy, and PP type were adjusted for, using logistic regression models.

Background: The aim of this study was to determine prognostic factors and to provide long-term mortality data in patients with positive lymph nodes at the time of radical prostatectomy in a sample with long-term follow-up.

Radical prostatectomy does not decrease long-term mortality in randomized trials involving such patients, but increases patient-reported adverse effects of incontinence and sexual dysfunction (1).

Purpose To analyze urinary continence outcome following robot-assisted radical prostatectomy (RARP) for aggressive prostate cancer in men aged ≥ 70 and < 70 years.

The aim of the present study was to determine factors associated with the development of biochemical recurrence following robot-assisted radical prostatectomy among those prostate cancer patients.

Laparoscopic Radical Prostatectomy (LRP) is a standard surgical approach for treating organ confined prostate cancer.

INTRODUCTION AND OBJECTIVES: Radical prostatectomy is the recommended definitive surgical treatment for organ-confined prostate cancer in eligible men who meet the criteria for curative radical therapy.

Objective To evaluate the benefit of radical prostatectomy (RP) in patients with lymph node-positive prostate cancer.

At a workshop in 2017, the Australian and New Zealand Faculty of Radiation Oncology Genito-Urinary Group (FROGG) identified variations in the management of node-positive prostate cancer identified on primary staging or on histopathology at radical prostatectomy.

In a discovery cohort of 753 men with localized high-risk (clinical stage T3-4 or PSA >20 ng/ml or Gleason sum 8-10) PCa undergoing radical prostatectomy, we noted that three specific factors identified men who bore the highest burden of metastasis and cancer-specific mortality: primary Gleason pattern 5 present on biopsy, or five or more biopsy cores containing Gleason sum 8-10, or presence of multiple high-risk features [8].

Methods Using data from the National Cancer Data Base, we identified 13,652 men with a high predicted probability of 10-year survival (≤ 65 years of age and Charlson Comorbidity Index score of 0) who underwent radical prostatectomy at 1023 facilities for biopsy-confirmed localized high-risk prostate cancer diagnosed between January 2004 and December 2011.

This prospective cohort study examined the relation between pre-diagnostic carbohydrate intake and treatment failure following radical prostatectomy for clinically early-stage PCa.

METHODS We conducted a prospective cohort study of 1641 men (773 ever-smokers) treated with radical prostatectomy or radiation between 2003 and 2010.

METHODS: This single-center, retrospective study included 72 men with prostate cancer who underwent 3T MRI before radical prostatectomy performed between April 2014 and August 2017 and whose lesions were microdissected from radical prostatectomy specimens and then tested with Decipher (89 lesions; 23 MRI invisible [PI-RADS v2 scores ⩽ 2] and 66 MRI visible [PI-RADS v2 scores ≥ 3]).

MethodsThis single-center, retrospective study included 72 nonconsecutive men with prostate cancer who underwent MRI before radical prostatectomy performed between April 2014 and August 2017 and whose MRI registered lesions were microdissected from radical prostatectomy specimens and then profiled using Decipher (89 lesions; 23 MRI invisible [PI-RADS v2 scores ≤ 2] and 66 MRI visible [PI-RADS v2 scores ≥ 3]).

BackgroundThe Cancer of the Prostate Risk Assessment (CAPRA) score was designed and validated several times to predict the biochemical recurrence-free survival after a radical prostatectomy.

ELAC2 protein expression was analyzed by immunohistochemistry in 9,262 patients and Kaplan-Meier curves of PSA recurrence-free survival were calculated in 8,513 patients treated with radical prostatectomy.

METHODS: Men undergoing a multiparametric prostate MRI (with T1, T2, diffusion weighted, and dynamic contrast enhanced sequences) between 2002-2013 at our institution prior to radical prostatectomy were identified.

MATERIALS AND METHODS A total of 113 patients with prostate cancer who underwent radical prostatectomy and prebiopsy multiparametric 3-T MRI (mpMRI) that included T2-weighted imaging, DWI, and dynamic contrast-enhanced MRI (DCE-MRI) were enrolled in a retrospective study conducted at two institutions.

BACKGROUND Available models for predicting lymph node invasion (LNI) in prostate cancer (PCa) patients undergoing radical prostatectomy (RP) might not be applicable to men diagnosed via magnetic resonance imaging (MRI)-targeted biopsies.

32Background: Current pre-radical prostatectomy (RP) nomograms predicting lymph node involvement (LNI) are based on systematic 12-core prostate biopsies (PBx).

INTRODUCTION AND OBJECTIVES: Radical Prostatectomy (RP) is the gold-standard surgical treatment for men diagnosed with organ-confined prostate cancer.

INTRODUCTION AND OBJECTIVES: Robot assisted radical prostatectomy (RARP) is in many countries the standard surgical treatment option in intermediate and high risk localised prostate cancer.