Effect of Age on Robotic-Assisted Radical Prostatectomy Outcomes: A Multi-center Analysis.

Area of Science:

• Urology
• Surgical Oncology
• Geriatric Medicine

Background:

• Robotic-assisted radical prostatectomy is a common treatment for prostate cancer.
• Age is a known risk factor for surgical complications.
• The clinical significance of age-related risk in robotic prostatectomy is not well-defined.

Purpose of the Study:

• To evaluate the association between patient age and perioperative complications after robotic-assisted radical prostatectomy.
• To determine if age-related increases in complication risk are clinically significant.

Main Methods:

• Pooled data from three institutions (Cornell, Georgetown, Memorial Sloan Kettering) from 2012-2022.
• Assessed major complications (Clavien-Dindo grade ≥3) within 30 days post-surgery.
• Used multivariable regression, adjusting for surgeon volume and oncologic risk factors.

Main Results:

• Overall major complication rates were similar across institutions (2.1-4.1%).
• Older age was associated with a statistically significant increased risk of complications (OR 1.03 per year).
• The absolute increase in risk was small; estimated risk for 60, 70, and 80-year-olds was 2.0%, 2.6%, and 3.3%, respectively.

Conclusions:

• Older age is associated with a slightly increased risk of major complications after robotic prostatectomy.
• The absolute increase in complication risk with age is not clinically significant.
• Age alone should not be the deciding factor for treatment in well-selected older prostate cancer patients.