Effects of aging on complications following robot-assisted radical prostatectomy

For prostate cancer (PCa) in the elderly, including patients ≥ 80 years, the safety of robot-assisted radical prostatectomy (RARP) is controversial. We aimed to evaluate the effect of aging on the postoperative complication rates after RARP.

This cohort study used a database of patients who had undergone RARP at 25 different institutes. We divided the cohort into four age groups (< 70, 70-74, 75-79, and ≥ 80 years). The complication rates after RARP in the 70-74, 75-79, and ≥ 80 year group were compared using the < 70 year group serving as the control group by applying the inverse probability of treatment weighting (IPTW)-adjusted regression analysis.

A total of 8055 patients were evaluated. The postoperative complication rates were 8.8%, 9.7%, 9.6%, and 10.0% in the < 70, 71-74, 75-79, and ≥ 80 age groups, respectively. In IPTW-adjusted analyses, the risk of overall complications (< 70 vs. 70-74 year group: OR = 1.09 [95% CI 0.92-1.29]; < 70 vs. 75-79 year group: OR = 1.09 [95% CI 0.88-1.37], and < 70 vs. ≥ 80 year group: OR = 2.21 [95% CI 0.92-5.32]) did not change with increasing age. There was no significant increase in risk for any complication category, such as bowel dysfunction, symptomatic lymphocele, or bacterial infection, between the < 70 and ≥ 80 age groups.

Our findings showed that, in appropriately selected patients, the risk of complications after RARP did not increase with age, even at 75 or 80 years.