Related Experiment Video
Updated: Oct 14, 2025
12:10
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
8.1K
[Deferred prostatectomy after active surveillance-results from a single center]
Zaid Al-Kailani1, Johannes Linxweiler2, Stefan Siemer2
1Universitätsklinikum des Saarlandes, Klinik für Urologie und Kinderurologie, Universität des Saarlandes, Kirrberger Straße 100, Gebäude 6, 66424, Homburg/Saar, Deutschland. zaid.al-kailani@uks.eu.
Urologie (Heidelberg, Germany)
|November 8, 2021
Summary
Active Surveillance (AS) for prostate cancer poses challenges. Deferred radical prostatectomy after AS showed significantly higher adverse pathology rates compared to immediate surgery, indicating potential oncological safety concerns.
Area of Science:
- Urology
- Oncology
- Prostate Cancer Management
Background:
- Active Surveillance (AS) for prostate cancer can cause patient and caregiver psychological burden.
- Successful implementation of AS is challenging due to constant clinical monitoring.
Purpose of the Study:
- To analyze reasons for AS termination.
- To compare the rate of adverse pathology (AP) in patients undergoing deferred radical prostatectomy (RP) versus immediate RP after AS.
Main Methods:
- Monocentric study comparing deferred RP after AS with immediate RP.
- Analysis of reasons for AS termination and postoperative AP rates.
- Statistical comparison using the Chi-squared test.
Main Results:
- After 21 months, 74 patients underwent deferred RP, while 214 had immediate RP.
- Adverse pathology (Gleason score ≥7b, ≥pT3a, R1, N+) was significantly higher in the AS group (45% vs. 29%, P<0.001).
Conclusions:
- Current AS protocols and tools may be inadequate for ensuring oncological safety.
- Development of new diagnostic tools, imaging techniques, and biomarkers is needed for better disease progression monitoring in AS candidates.
