Cognitive function in patients undergoing robotic radical prostatectomy - 1 year follow up

Postoperative neurocognitive disorders are clinically relevant, yet longitudinal data in patients undergoing radical prostatectomy are limited. This study aimed to evaluate longitudinal changes in cognitive function and identify factors associated with cognitive trajectories in patients undergoing robotic radical prostatectomy for prostate cancer. The study included 66 patients undergoing robotic radical prostatectomy for prostate cancer. Assessments were performed at baseline (at median 10 days before surgery), 6 months, and 12 months postoperatively. Evaluations included demographic and clinical data, cognitive performance (Neurotest), affective and depressive symptoms (HADS), and affective temperament (TEMPS-A). Global cognitive composite (GCC) scores changed significantly over time (baseline, 6, and 12 months after prostatectomy), while most individual domains remained stable. In the initial model, affective temperament was associated with cognitive change: depressive temperament showed a positive association (β = 0.37, p = 0.017), whereas anxious temperament showed a non-significant negative trend (β = -0.28, p = 0.061). In the adjusted model, baseline GCC was a strong independent predictor (β = -0.63, p < 0.001). Both depressive (β = 0.34, p = 0.009) and anxious temperament (β = -0.31, p = 0.013) remained significantly associated with cognitive trajectories, while physical activity and depressive symptoms (HADS-D) were not. Cognitive trajectories after robotic radical prostatectomy are dynamic may be related to psychological and clinical factors. These findings support longitudinal cognitive monitoring and highlight the potential value of incorporating psychological assessment into perioperative care to identify patients at risk of poorer cognitive outcomes.