Incidental prostate carcinoma after single-port robot-assisted simple prostatectomy: a multi-institutional report...

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• Single-port robot-assisted simple prostatectomy offers a minimally invasive option for benign prostatic hyperplasia.
• Incidental prostate cancer detection rates after simple prostatectomy vary widely in existing literature.
• Assessing incidental prostate cancer rates is crucial for patient management and surgical planning.

Purpose of the Study:

• To determine the rate of incidental prostate cancer following single-port robot-assisted simple prostatectomy.
• To compare these findings with rates reported for other surgical approaches.

Main Methods:

• A multi-institutional retrospective analysis of 235 consecutive single-port robot-assisted simple prostatectomy cases (2019-2023).
• Eleven surgeons across six centers participated in the Single-Port Advanced Research Consortium (SPARC) study.
• Pathological analysis of adenoma specimens was the primary outcome measure.

Main Results:

• Eleven patients (4.6%) were diagnosed with incidental prostate cancer.
• The median tumor involvement was 5% of the tissue, with a 2.1% rate of clinically significant prostate cancer.
• Most detected cancers were Gleason Grade Group 1; higher-grade cancers were managed with further treatment or surveillance.

Conclusions:

• Single-port robot-assisted simple prostatectomy demonstrated a 4.6% incidental prostate cancer detection rate.
• This rate is comparable to established multi-port, laparoscopic, and open simple prostatectomy techniques.
• The findings support the oncological safety and efficacy of this minimally invasive approach.