Outcome of Robotic Radical Prostatectomy in Men Over 74

Area of Science:

• Urology
• Oncologic Surgery
• Geriatric Medicine

Background:

• Robotic radical prostatectomy (RARP) is a standard treatment for prostate cancer.
• Outcomes in elderly patients (≥75 years) undergoing RARP require specific evaluation.
• Previous studies have not extensively detailed functional and oncological results in this demographic.

Purpose of the Study:

• To evaluate the safety and efficacy of RARP in patients aged 75 and older.
• To compare functional outcomes (urinary continence, erectile function) and oncological results between patients ≥75 and <75 years old.
• To identify preoperative factors influencing outcomes in elderly patients undergoing RARP.

Main Methods:

• Retrospective analysis of 647 patients who underwent RARP.
• Patients were divided into two groups: <75 years and ≥75 years.
• Preoperative factors, operative characteristics, histopathological results, and 12-month functional outcomes (PSA, continence, potency) were assessed.

Main Results:

• No significant differences in major or minor complication rates between age groups.
• Patients ≥75 had worse baseline International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF) scores.
• Higher rates of R1-resections and PSA relapse at 1 year were observed in the ≥75 group, with no significant difference in 12-month pad-free continence or erectile function preservation.

Conclusions:

• RARP can be performed safely in patients ≥75 years with favorable functional and histopathological outcomes.
• Elderly patients (≥75) can achieve comparable functional results to younger patients post-RARP.
• Age alone should not be a contraindication for radical prostatectomy in elderly men.