Outcomes after precision prostatectomy: safety, efficacy and transference of skills

• Published in: World journal of urology 2024-07, Vol.42 (1), p.394, Article 394
• Main Authors: Kolanukuduru, Kaushik P., Busby, Dallin, Grauer, Ralph, Choudhary, Manish K., Mandel, Asher, Maheshwari, Ashutosh, Tewari, Ash K., Menon, Mani
• Format: Article
• Language: English
• Subjects: Aged; Biopsy; Cancer; Clinical Competence; Complications; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Oncology; Original Article; Postoperative; Prostatectomy; Prostatectomy - methods; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Treatment Outcome; Urology
• ISSN: 1433-8726; 0724-4983; 1433-8726
• DOI: 10.1007/s00345-024-05074-2

Purpose Precision Prostatectomy (PP) is a viable treatment option for men with unilateral dominant cancer who are interested in preserving functional outcomes. To date, the data published about the outcomes of this technique has come from a single center only (Henry Ford - HF). We present the surgical, functional, and oncological outcomes of the first series of patients to undergo PP outside of HF, to demonstrate the safety and reproducibility of the technique. Methods Between 2022 and 2023, PP was offered to select patients who were interested in preserving their functional status. Men who underwent PP were followed at 3 monthly intervals; information regarding their functional status was simultaneously obtained. Men who had biochemical recurrence were advised to undergo remnant biopsy. If residual cancer was detected, then remnant removal was performed. Results The median age and median PSA of the study group was 63 years and 6.89 ng/ml respectively. The median operative and console times were 196.5 and 154 minutes. No intra-operative complications were noted. Three patients had a total of three post-operative complications. Three patients had biochemical recurrence; cancer was not detected in any of these patients on postoperative biopsies of the prostatic remnant. At 12 months, 91% of patients reported using 0 pads/day and 90.9% of pre-operatively potent patients were potent at 12 months. Conclusion PP is a safe and reproducible technique that can ensure cancer control and preservation of functional status in select patients. Further studies with large sample sizes and longer follow-up are required to ascertain the long-term outcomes of this surgical technique.