THE JOURNAL OF UROLOGYâ
Vol. 195, No. 4S, Supplement, Monday, May 9, 2016
Trial and 4 yrs data conﬁrmed our previous ﬁndings. In other words RARP provided better functional results in terms of the recovery of continence and potency; these results are stable during the follow up period. Source of Funding: none
PD37-10 LONG-TERM ONCOLOGICAL OUTCOMES IN PATIENTS WITH BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY Raisa Pompe*, Philipp Gild, Philipp Mandel, Felix Chun, Hartwig Huland, Markus Graefen, Derya Tilki, Hamburg, Germany Source of Funding: None
PD37-09 LAPAROSCOPIC VERSUS ROBOT-ASSISTED RADICAL PROSTATECTOMY: FOUR-YEAR RESULTS OF A PROSPECTIVE RANDOMISED TRIAL Cristian Fiori*, Ivano Morra, Matteo Manfredi, Fabrizio Mele, Riccardo Bertolo, Giovanni Cattaneo, Massimiliano Poggio, Daniele Amparore, Sabrina De Cillis, Enrico Checcucci, Stefano De Luca, Francesco Porpiglia, Orbassano, Torino, Italy INTRODUCTION AND OBJECTIVES: The advantages of robotic assisted over laparoscopic radical prostatectomy (RARP over LRP) have rarely been investigated in a randomised controlled trial. We have previously reported the perioperative and 1 y-results of a prospective randomized trial comparing RARP and LRP. The aim of this study was to evaluate 4-yr results from that trial. METHODS: From January 2010 to January 2011, 120 patients (40-75 yrs.) with organ-conﬁned prostate cancer (T1-2-N0 M0 clinically staged according to TNM 2009) and to whom radical prostatectomy was proposed were enrolled and randomly assigned (using a randomization plan) to one of two groups based on surgical approach: the RARP group and the LRP group. All interventions were performed with transperitoneal anterograde technique by the same surgeon. Continence and potency were evaluated after 1, 2, 3 and 4 year. Patients were deﬁned as continent if they did not use any pads or used one safety pad per day. In the NS-cohort, erectile function recovery with or without PDE5-I treatment was deﬁned by using the IIEF-5 questionnaire, we considered patients to be potent with an IIEF-5 score >17. Patients who experienced biochemical recurrence and required adjunctive therapy (radiation therapy and/or hormonal treatment) were registered and compared. Student’s t-test, Mann-Whitney test, Chi-Square test, Pearson Chi square test and multiple regression analysis were used for statistics. RESULTS: The two groups (RARP n¼ 60, LRP n¼60) were comparable in terms of demographic and pathological data. The continence rate was higher in the RARP group at 1 y time-point: the overall continence rate was 95.0% and 83.3%, respectively (p¼0.042); RARP vs LRP respectively) and these rates did not change signiﬁcantly after 2, 3, and 4 years. 12 months after surgery, among preoperative potent patients treated with nerve-sparing techniques (35 in both groups) the rate of erection recovery was 80.0% and 54.2%, respectively (p¼0.020). These rates progressively increased until 88.5% and 62.8% respectively, 4 y after surgery. Stepwise regression analysis showed that surgical approach was an independent prognostic factor for continence at every time points. Overall, during the follow up, 12 patients in the RARP group and 11 in the LRP group (p¼0.8) underwent radiation therapy and/or hormonal treatment. CONCLUSIONS: This study represents the secondary, midterm analysis of a previously published
INTRODUCTION AND OBJECTIVES: Patients with biochemical recurrence (BCR) after radical prostatectomy (RP) do not always progress to systemic disease or cancer-speciﬁc death. The aim of the study was to study the long-term oncological outcomes of patients with BCR and to identify predictors of metastasis and prostate cancer (PCa) death in these men. METHODS: We retrospectively analyzed the data of 4241 men who underwent RP between January 1992 and 2005. Patients who received neoadjuvant or adjuvant treatment were excluded from the study. Multivariate regression analyses were performed to identify prognosticators of oncologic outcomes in these patients. RESULTS: Median follow-up was 120.9 months. Of 4241 men, 1190 (28.1%) had BCR (PSA level ¼ 0.2 ng/ml) within the follow-up period. Metastasis-free survival (MFS) at 10 years after surgery was 96.1% (95%CI: 95.4%-96.7%). 181 of the 1190 patients with BCR (15.2%) developed metastasis. Median time from BCR to metastases was 46 months. In multivariate analysis, time to BCR and Gleason score were signiﬁcantly associated with the development metastasis. Moreover, the interval from RP to metastasis was predictive of time to cancer-speciﬁc death. CONCLUSIONS: Only a small proportion of patients with BCR develops metastasis. Shorter time between RP and BCR was identiﬁed as an adverse prognostic factor. Our data may be beneﬁcial for counseling of patients regarding salvage treatments. Source of Funding: None
PD37-11 FUNCTIONAL OUTCOMES AFTER EXTENDED VS. SUPER-EXTENDED PELVIC LYMPH NODE DISSECTION FOR INTERMEDIATE AND HIGH-RISK LOCALIZED PROSTATE CANCER. Steven Joniau*, Pieter Janssen, Lorenzo Tosco, Wouter Everaerts, Maarten Albersen, Ben Van Cleynenbreugel, Hein Van Poppel, Leuven, Belgium INTRODUCTION AND OBJECTIVES: There is ongoing discussion about the extent of lymph node dissection (LND) at radical prostatectomy (RP) for intermediate/high risk prostate cancer (PCa). Besides a doubtful impact on oncological outcomes, extending the LND beyond the accepted limits of an extended LND (eLND) may also adversely affect functional results. We aimed to determine whether performing a super-extended LND (seLND) has a negative effect on the recovery of urinary continence and erectile function (EF) after radical prostatectomy compared to an eLND. METHODS: 544 patients underwent RP + eLND or seLND between January 2007 and December 2013. All patients were asked to ﬁll out the IIEF-5 and an in-house developed continence questionnaire (no loss + no pads / 1 pad per day / more than 1 pad per day) assessing EF and continence. Only patients who ﬁlled out the questionnaires on at least 2 occasions, were analysed. This resulted in 171 patients remaining for analysis.