Anticancer research · 2025
The Posterior First Approach in Robot-assisted Radical Prostatectomy for Prostate Cancer Reduces Positive Surgical Margins on the Bladder Neck Side.
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Nakai Yasushi, Tanaka Nobumichi, Onishi Kenta, Goto Daisuke, Morizawa Yosuke, Hori Shunta, Miyake Makito, Fujimoto Kiyohide
Аннотация
BACKGROUND/AIM: There is limited data comparing outcomes and quality of life between the conventional robot-assisted radical prostatectomy (RARP) (anterior approach) and the posterior first approach RARP. In the present study, we evaluated the differences between conventional and posterior first approach RARP.
PATIENTS AND METHODS: This study enrolled consecutive patients who underwent conventional RARP (n=255) and posterior first approach RARP (n=107). Propensity scores were calculated, and patients were matched in a 1:1 ratio based on these scores. The quality of life (QOL), continence, and perioperative outcomes were evaluated in the two groups.
RESULTS: Using propensity matching, 99 patients were included in each group. The number of patients (75%) whose bladder necks were preserved in the posterior first approach RARP group was significantly higher (p<0.001) than that in the conventional RARP group (42%). Positive surgical margin on the side of the bladder neck in the posterior first approach group (1%) was not significantly (p=0.03) detected compared to that in the conventional group (8%). There was no significant difference in QOL score at 12 months after RARP or in continence rate within 12 months after RARP.
CONCLUSION: Compared to the conventional approach, the posterior first approach RARP can preserve the bladder neck and reduce the incidence of positive surgical margins at the bladder neck side.
PATIENTS AND METHODS: This study enrolled consecutive patients who underwent conventional RARP (n=255) and posterior first approach RARP (n=107). Propensity scores were calculated, and patients were matched in a 1:1 ratio based on these scores. The quality of life (QOL), continence, and perioperative outcomes were evaluated in the two groups.
RESULTS: Using propensity matching, 99 patients were included in each group. The number of patients (75%) whose bladder necks were preserved in the posterior first approach RARP group was significantly higher (p<0.001) than that in the conventional RARP group (42%). Positive surgical margin on the side of the bladder neck in the posterior first approach group (1%) was not significantly (p=0.03) detected compared to that in the conventional group (8%). There was no significant difference in QOL score at 12 months after RARP or in continence rate within 12 months after RARP.
CONCLUSION: Compared to the conventional approach, the posterior first approach RARP can preserve the bladder neck and reduce the incidence of positive surgical margins at the bladder neck side.