Outcomes of Robot-assisted Radical Prostatectomy in Men Aged 75 Years Old or Older: A Single-center Study in Thailand

Attapol Mahalelakul; Pubordee Assavavirojekul; Sunai Leewansangtong; Varat Woranisarakul; Thitipat Hansomwong; Sittiporn Srinualnad

doi:10.33192/smj.v77i1.271301

Authors

Attapol Mahalelakul Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Pubordee Assavavirojekul Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Sunai Leewansangtong Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Varat Woranisarakul Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Thitipat Hansomwong Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Sittiporn Srinualnad Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.33192/smj.v77i1.271301

Keywords:

Prostate cancer, Robot-assisted radical prostatectomy, Elderly, Outcome, Biochemical recurrence

Abstract

Objective: The aim of this study was to evaluate the surgical, oncological outcomes, and complications in men ≥75 years of age who have undergone robot-assisted radical prostatectomy (RARP).

Materials and Methods: A retrospective analysis was performed on data from patients who underwent RARP between July 2018 and December 2020. This analysis included the patients’ characteristics, perioperative outcomes, postoperative outcomes, oncologic outcome and biochemical recurrence(BCR) comparing an elderly group (≥75 years old) with a younger group (<75 years old).

Results: In total, 455 patients were classified into two groups: 57 patients aged ≥75 and 398 patients aged <75 years old. No significant differences were observed in BCR at 12 months10.3% vs. 17.5% (p=0.1), perioperative and postoperative complications, pathological positive lymph node, or resection margins. The pathological T-staging and Gleason grade groups were more aggressive in the older group with pT3 64.9 vs. 48.7% (p < 0.05) and Gleason grade group 4 and 5 41.3% vs. 25.1%, (p < 0.05).

Conclusion: RARP is safe and feasible procedure in selected elderly patients, offering comparable perioperative and postoperative surgical outcomes to those seen in younger patients.

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