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Título

EVALUATION OF PENTAFECTA IN ROBOT-ASSISTED RADICAL PROSTATECTOMY DURING THE INITIAL EXPERIENCE IN A UNIVERSITY HOSPITAL

Resumo

Introduction: Robotic-assisted radical prostatectomy (RARP) is an option for the treatment of localized prostate cancer. The objective of the present study was to evaluate the Pentafecta outcomes (biochemical recurrence, continence, potency, surgical complications and surgical margins) in patients undergoing RARP during the initial experience in a university hospital.

Materials and Methods: A retrospective evaluation of medical records was performed from a cohort with a prospective registry of the outcomes of 163 patients submitted to RARP for localized prostate adenocarcinoma between August 2013 and October 2019.

Results: 163 RARP were performed, mean age 64.16 ± 6.54 years, PSA 6.20 (IQR = 4.91 – 8.95) ng/dl, BMI 27.14 (IQR = 24.22 – 29,26) kg/m2, D’Amico risk classification was 35 (22.3%) low risk, 81 (51.6%) intermediate risk and 41 (26.1%) high risk. One hundred and fifty-four patients entered the analysis of pentafecta with a rate of 38,3% reaching this outcome. Complications: 23 patients had minor complications (Clavien I and II) and 8 patients had major complications (Clavien IIIa, IIIb and IVa). Surgical margins were negative in 69.9% of patients. The biochemical recurrence-free rate was 89.5%. The overall continence rate was 93.5% and the potency rate was 63.5%. Multivariate analysis showed that T2 patients had a 2.68 times greater chance of reaching Pentafecta than patients ≥ T3 (p <0.05), while age and BMI data were presented as a protective factor with RR of 0.95 and 0.94, respectively.

Conclusion: It is possible to achieve good overall results using pentafecta as the ideal RARP outcome during the learning curve.

Palavras Chave ( separado por ; )

pentafecta; prostatectomy, robotic, continence, initial experience