Pathologic and Short-Term Oncologic Outcomes of Prostate Cancer Patients Following Transvesical Robot-Assisted Radical Prostatectomy

To study the pathologic and short-term oncological and survival outcomes following Transvesical Single-Port Robot-Assisted Radical Prostatectomy.

A retrospective review was performed on prospectively collected data on 169 patients with low and intermediate-risks prostate cancer, who either underwent Single-Port Transvesical or Multi-Port Transperitoneal Radical Prostatectomy by a single surgeon between 2015 and 2022. Preoperative clinicopathologic characteristics, as well as final histopathology outcomes, were compared. Univariate Cox proportional hazard analysis was used to evaluate the impact of the surgical approach on biochemical recurrence-free survival within 12 months.

Single-Port Transvesical and Multi-Port Transperitoneal Robotic Radical Prostatectomy were completed in 85 and 84 patients, respectively. Preoperative clinicopathologic features were similar between the 2 groups. In terms of histopathology outcomes, the 2 groups had identical final Gleason Grades, T stage, as well as the rates of adverse pathological features and positive surgical margins (P = >0.05). Despite the lower median number of nodes in the single-port cohort of 2 (0-5) compared to 6 (4-9) in the multi-port cohort (P = <0.001), there remained no statistically significant difference in the rates of lymph node invasion (P = 0.08). At a median follow-up of 12 months, there were no differences in the biochemical recurrence-free survival rates among both groups (P = 0.38). Univariate Cox proportional hazard analysis did not consider surgical approach to be an independent predictor of biochemical recurrence (HR 0.53, 95%CI 0.13-2.23, P = 0.39).

In well-selected patients, single-port transvesical robotic radical prostatectomy provided a similar short-term oncologic control as the multi-port approach with similar surgical margin status and 1-year biochemical recurrence rates.