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11.05.2019 | Original Article

Recovery of pad-free continence in elderly men does not differ from younger men undergoing robot-assisted radical prostatectomy for aggressive prostate cancer

verfasst von: Joanne Nyaboe Nyarangi-Dix, Georgi Tosev, Ivan Damgov, Philipp Reimold, Cem Aksoy, Gencay Hatiboglu, Dogu Teber, Josef Mansour, Franklin Emmanuel Kuehhas, Jan Philipp Radtke, Markus Hohenfellner

Erschienen in: World Journal of Urology | Ausgabe 2/2020

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Abstract

Purpose

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

Methods

Retrospective analyses of prospectively collected long-term data from a monocentric cohort of 350 men with D’Amico high-risk prostate cancer undergone robot-assisted radical prostatectomy at a single institution between 2005 and 2016. The association between time since operation and zero-pad urinary continence recovery was comparatively analyzed by separate pre-operative and post-operative Cox proportional-hazard regression models.

Results

Median age in the age group ≥ 70 years was 73 years compared with 62 years in the < 70 year age group. Distribution of men receiving adjuvant and salvage radiotherapy/hormonal therapy was similar in both age groups. Urinary continence recovery rate at 12, 24, and 36 months after surgery of men aged ≥ 70 years was 66, 79 and 83%, respectively, and statistically similar to that of men < 70 years: 71, 81, and 85% (log-rank test p = 0.24). Multivariable analyses demonstrated no significant difference in return to continence between the two age groups (p = 0.28 and p = 0.17). In addition, clinical stage and type of nerve sparing (unilateral, bilateral or non-nerve sparing) were found to be independently predictive of pad-free continence recovery.

Conclusions

Regardless of age, return to continence in men with aggressive prostate cancer undergoing RARP continues to improve way beyond the first 12 months after surgery. Considering the dire effects of post-operative radiotherapy on continence in this aggressive cancer cohort, advanced age alone should not discourage recommending multimodal therapy involving RARP.

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Titel: Recovery of pad-free continence in elderly men does not differ from younger men undergoing robot-assisted radical prostatectomy for aggressive prostate cancer
verfasst von: Joanne Nyaboe Nyarangi-Dix
Georgi Tosev
Ivan Damgov
Philipp Reimold
Cem Aksoy
Gencay Hatiboglu
Dogu Teber
Josef Mansour
Franklin Emmanuel Kuehhas
Jan Philipp Radtke
Markus Hohenfellner
Publikationsdatum: 11.05.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 2/2020
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02797-5

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Recovery of pad-free continence in elderly men does not differ from younger men undergoing robot-assisted radical prostatectomy for aggressive prostate cancer

Abstract

Purpose

Methods

Results

Conclusions

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