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Updated: Aug 23, 2025

Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Surgical Tolerability and Frailty in Elderly Patients Undergoing Robot-Assisted Radical Prostatectomy: A Narrative
Yuta Yamada1, Satoru Taguchi1, Haruki Kume1
1Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo 113-8655, Japan.
Abstract:
Robot-assisted radical prostatectomy (RARP) has now become the gold standard treatment for localized prostate cancer. There are multiple elements in decision making for the treatment of prostate cancer. One of the important elements is life expectancy, which the current guidelines recommend as an indicator for choosing treatment options. However, determination of life expectancy can be complicated and difficult in some cases. In addition, surgical tolerability is also an important issue. Since frailty may be a major concern, it may be logical to use geriatric assessment tools to discriminate 'surgically fit' patients from unfit patients. Landmark studies show two valid models such as the phenotype model and the cumulative deficit model that allow for the diagnosis of frailty. Many studies have also developed geriatric screening tools such as VES-13 and G8. These tools may have the potential to directly sort out unfit patients for surgery preoperatively.

