Multicenter Experience With Robot-assisted Radical Prostatectomy in Renal Transplant Recipients

Objective To evaluate our multi-institutional outcome with robot-assisted radical prostatectomy (RARP) in renal transplant recipients and describe technical modifications of the procedure. Materials and Methods We retrospectively reviewed 1677 patients, 1422 from Mayo Clinic Arizona and 255 from Loy...

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Bibliographic Details
Published in:Urology (Ridgewood, N.J.) N.J.), 2012-12, Vol.80 (6), p.1267-1272
Main Authors: Polcari, Anthony J, Allen, Joseph C, Nunez-Nateras, Rafael, Mmeje, Chinedu O, Andrews, Paul E, Milner, John E, Castle, Erik P, Woods, Michael E
Format: Article
Language:English
Subjects:
Adenocarcinoma - epidemiology
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Biological and medical sciences
Female
Humans
Kidney Diseases - epidemiology
Kidney Diseases - surgery
Kidney Transplantation
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Prostatectomy - methods
Prostatic Neoplasms - epidemiology
Prostatic Neoplasms - pathology
Prostatic Neoplasms - surgery
Retrospective Studies
Robotics - methods
Urology
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Summary:Objective To evaluate our multi-institutional outcome with robot-assisted radical prostatectomy (RARP) in renal transplant recipients and describe technical modifications of the procedure. Materials and Methods We retrospectively reviewed 1677 patients, 1422 from Mayo Clinic Arizona and 255 from Loyola University Medical Center, undergoing RARP from March 2004 to October 2010, of which 7 were renal transplant recipients. Baseline demographic features, perioperative data, and oncologic outcomes were reviewed. Results At diagnosis, mean patient age was 63.3 years and serum prostate specific antigen was 6.17 ng/mL. The mean total operative time was 186 minutes (range, 80-210 minutes). No intraoperative complications were noted. The mean hospital length of stay was 1.8 days (range, 1-3 days). Clavien grade II postoperative complications occurred in 3 of the 7 patients (42.9%), consisting of urosepsis, atrial fibrillation, and gross hematuria, all resolving with appropriate medical management. No significant changes were observed in graft function. Two patients (28.6%) had positive surgical margins. During a mean follow-up of 16 months, 1 patient with pathologic T3a, Gleason 9 cancer experienced a biochemical recurrence, which was treated with salvage external-beam radiation and androgen-deprivation therapy. Conclusion Our series suggests that RARP is a safe and feasible form of therapy for localized prostate cancer in a select group of renal transplant recipients.
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2012.08.048