Retzius‐sparing versus standard robot‐assisted laparoscopic prostatectomy: A two‐year patient‐reported and oncological assessment
Purpose To evaluate the two‐year functional and oncological outcomes of Retzius‐sparing robot‐assisted laparoscopic prostatectomy (rsRALP) and standard approach (sRALP). Methods A total of 200 consecutive patients who underwent either sRALP (n = 100) or rsRALP (n = 100) for clinically localized PCa...
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| Veröffentlicht in: | The Prostate 2025-02, Vol.85 (2), p.115-122 |
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| creator | Diamand, Romain Bernard, Pierre‐Loup Mjaess, Georges Benijts, Jan Assenmacher, Christophe Assenmacher, Grégoire |
| description | Purpose
To evaluate the two‐year functional and oncological outcomes of Retzius‐sparing robot‐assisted laparoscopic prostatectomy (rsRALP) and standard approach (sRALP).
Methods
A total of 200 consecutive patients who underwent either sRALP (n = 100) or rsRALP (n = 100) for clinically localized PCa at a single referral European center between 2015 and 2020 were identified from a prospectively cohort, as part of the Belgian Cancer Registry. Primary outcomes included functional outcomes and quality of life (QoL) using validated patient‐reported outcome measures (PROMs) assessed at 1‐, 3‐, 12‐, and 24‐months post‐surgery. Secondary outcomes comprised oncological outcomes reported as positive surgical margins (PSM) and 5‐year biochemical recurrence (BCR). Kaplan‐Meier analysis with log‐rank test and multivariable Cox regression were used.
Results
The median follow‐up was 60 months. No significant differences were observed between the surgical approaches in terms of patient and tumor characteristics. Urinary function and QoL were significantly better at each follow‐up period (all p ≤ 0.01) with rsRALP, while sexual function was not significantly different 12 months after surgery. No significant difference in positive surgical margins rate was observed between surgical approaches (31% vs 32%, p = 0.9). Retzius‐sparing RALP was associated with longer PSM lengths (5 mm vs 2.5 mm, p = 0.02), a higher multifocality rate (34% vs. 13%, p |
| doi_str_mv | 10.1002/pros.24807 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3114502223</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3114502223</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2827-a9772619a39f3e001ece7b926fa3a199a928f4bd6486eb7f7247154a4dc22fe83</originalsourceid><addsrcrecordid>eNp90ctu1TAQBmALUdFDYcMDIEtsEFKKbyeO2VUVl0qVigqso4kzqVIlcfA4VIcVW3Y8I0-C01O6YMHKC3_zezzD2DMpjqUQ6vUcAx0rUwn7gG2kcLYQwmwfso1QVhRGanvIHhNdC5G5UI_YoXa6Eka7Dft5iel7v9DvH79ohthPV_wbRlqIU4KphdjyGJqQ8j0Q9ZSw5QNkGciHufd8fTxBQp_CuHvDT3i6CRnvECKfIfU4rbUR5xDX2pzJw-TDEK56DwPPoUg0ZvWEHXQwED69O4_Yl3dvP59-KM4v3p-dnpwXXlXKFuCsVaV0oF2nMX8JPdrGqbIDDdI5cKrqTNOWpiqxsZ1VxsqtAdN6pTqs9BF7uc_NnX9dkFI99uRxGGDCsFCtpTRboZTSmb74h16HJU65u6yMcbIqS5XVq73yeRQUsavn2I8Qd7UU9bqgep1RfbugjJ_fRS7NiO09_buRDOQe3PQD7v4TVX-8vPi0D_0DR3Siow</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3144918662</pqid></control><display><type>article</type><title>Retzius‐sparing versus standard robot‐assisted laparoscopic prostatectomy: A two‐year patient‐reported and oncological assessment</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Diamand, Romain ; Bernard, Pierre‐Loup ; Mjaess, Georges ; Benijts, Jan ; Assenmacher, Christophe ; Assenmacher, Grégoire</creator><creatorcontrib>Diamand, Romain ; Bernard, Pierre‐Loup ; Mjaess, Georges ; Benijts, Jan ; Assenmacher, Christophe ; Assenmacher, Grégoire</creatorcontrib><description>Purpose
To evaluate the two‐year functional and oncological outcomes of Retzius‐sparing robot‐assisted laparoscopic prostatectomy (rsRALP) and standard approach (sRALP).
Methods
A total of 200 consecutive patients who underwent either sRALP (n = 100) or rsRALP (n = 100) for clinically localized PCa at a single referral European center between 2015 and 2020 were identified from a prospectively cohort, as part of the Belgian Cancer Registry. Primary outcomes included functional outcomes and quality of life (QoL) using validated patient‐reported outcome measures (PROMs) assessed at 1‐, 3‐, 12‐, and 24‐months post‐surgery. Secondary outcomes comprised oncological outcomes reported as positive surgical margins (PSM) and 5‐year biochemical recurrence (BCR). Kaplan‐Meier analysis with log‐rank test and multivariable Cox regression were used.
Results
The median follow‐up was 60 months. No significant differences were observed between the surgical approaches in terms of patient and tumor characteristics. Urinary function and QoL were significantly better at each follow‐up period (all p ≤ 0.01) with rsRALP, while sexual function was not significantly different 12 months after surgery. No significant difference in positive surgical margins rate was observed between surgical approaches (31% vs 32%, p = 0.9). Retzius‐sparing RALP was associated with longer PSM lengths (5 mm vs 2.5 mm, p = 0.02), a higher multifocality rate (34% vs. 13%, p < 0.001), more occurrences in organ‐confined disease (59% vs. 39%, p < 0.001) and at anterior locations (37% vs. 16%, p = 0.05). Five‐year BCR‐free survival was not significantly different, and surgical approach was not a predictor of BCR.
Conclusions
The rsRALP approach significantly improves both early and short‐term urinary function and QoL compared to sRALP. Despite being associated with worse PSM characteristics, no significant decrease in BCR‐free survival was observed with rsRALP.</description><identifier>ISSN: 0270-4137</identifier><identifier>ISSN: 1097-0045</identifier><identifier>EISSN: 1097-0045</identifier><identifier>DOI: 10.1002/pros.24807</identifier><identifier>PMID: 39380439</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; functional outcomes ; Humans ; Laparoscopy ; Laparoscopy - adverse effects ; Laparoscopy - methods ; Male ; Margins of Excision ; Middle Aged ; Organ Sparing Treatments - methods ; Patient Reported Outcome Measures ; Prospective Studies ; prostate cancer ; Prostatectomy ; Prostatectomy - methods ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - surgery ; Quality of Life ; radical prostatectomy ; Retzius‐sparing ; Robotic Surgical Procedures - adverse effects ; Robotic Surgical Procedures - methods ; Surgery ; Survival ; Treatment Outcome</subject><ispartof>The Prostate, 2025-02, Vol.85 (2), p.115-122</ispartof><rights>2024 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2827-a9772619a39f3e001ece7b926fa3a199a928f4bd6486eb7f7247154a4dc22fe83</cites><orcidid>0000-0002-8703-4611 ; 0000-0002-2016-8543</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpros.24807$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpros.24807$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39380439$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Diamand, Romain</creatorcontrib><creatorcontrib>Bernard, Pierre‐Loup</creatorcontrib><creatorcontrib>Mjaess, Georges</creatorcontrib><creatorcontrib>Benijts, Jan</creatorcontrib><creatorcontrib>Assenmacher, Christophe</creatorcontrib><creatorcontrib>Assenmacher, Grégoire</creatorcontrib><title>Retzius‐sparing versus standard robot‐assisted laparoscopic prostatectomy: A two‐year patient‐reported and oncological assessment</title><title>The Prostate</title><addtitle>Prostate</addtitle><description>Purpose
To evaluate the two‐year functional and oncological outcomes of Retzius‐sparing robot‐assisted laparoscopic prostatectomy (rsRALP) and standard approach (sRALP).
Methods
A total of 200 consecutive patients who underwent either sRALP (n = 100) or rsRALP (n = 100) for clinically localized PCa at a single referral European center between 2015 and 2020 were identified from a prospectively cohort, as part of the Belgian Cancer Registry. Primary outcomes included functional outcomes and quality of life (QoL) using validated patient‐reported outcome measures (PROMs) assessed at 1‐, 3‐, 12‐, and 24‐months post‐surgery. Secondary outcomes comprised oncological outcomes reported as positive surgical margins (PSM) and 5‐year biochemical recurrence (BCR). Kaplan‐Meier analysis with log‐rank test and multivariable Cox regression were used.
Results
The median follow‐up was 60 months. No significant differences were observed between the surgical approaches in terms of patient and tumor characteristics. Urinary function and QoL were significantly better at each follow‐up period (all p ≤ 0.01) with rsRALP, while sexual function was not significantly different 12 months after surgery. No significant difference in positive surgical margins rate was observed between surgical approaches (31% vs 32%, p = 0.9). Retzius‐sparing RALP was associated with longer PSM lengths (5 mm vs 2.5 mm, p = 0.02), a higher multifocality rate (34% vs. 13%, p < 0.001), more occurrences in organ‐confined disease (59% vs. 39%, p < 0.001) and at anterior locations (37% vs. 16%, p = 0.05). Five‐year BCR‐free survival was not significantly different, and surgical approach was not a predictor of BCR.
Conclusions
The rsRALP approach significantly improves both early and short‐term urinary function and QoL compared to sRALP. Despite being associated with worse PSM characteristics, no significant decrease in BCR‐free survival was observed with rsRALP.</description><subject>Aged</subject><subject>functional outcomes</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - adverse effects</subject><subject>Laparoscopy - methods</subject><subject>Male</subject><subject>Margins of Excision</subject><subject>Middle Aged</subject><subject>Organ Sparing Treatments - methods</subject><subject>Patient Reported Outcome Measures</subject><subject>Prospective Studies</subject><subject>prostate cancer</subject><subject>Prostatectomy</subject><subject>Prostatectomy - methods</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Quality of Life</subject><subject>radical prostatectomy</subject><subject>Retzius‐sparing</subject><subject>Robotic Surgical Procedures - adverse effects</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Surgery</subject><subject>Survival</subject><subject>Treatment Outcome</subject><issn>0270-4137</issn><issn>1097-0045</issn><issn>1097-0045</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90ctu1TAQBmALUdFDYcMDIEtsEFKKbyeO2VUVl0qVigqso4kzqVIlcfA4VIcVW3Y8I0-C01O6YMHKC3_zezzD2DMpjqUQ6vUcAx0rUwn7gG2kcLYQwmwfso1QVhRGanvIHhNdC5G5UI_YoXa6Eka7Dft5iel7v9DvH79ohthPV_wbRlqIU4KphdjyGJqQ8j0Q9ZSw5QNkGciHufd8fTxBQp_CuHvDT3i6CRnvECKfIfU4rbUR5xDX2pzJw-TDEK56DwPPoUg0ZvWEHXQwED69O4_Yl3dvP59-KM4v3p-dnpwXXlXKFuCsVaV0oF2nMX8JPdrGqbIDDdI5cKrqTNOWpiqxsZ1VxsqtAdN6pTqs9BF7uc_NnX9dkFI99uRxGGDCsFCtpTRboZTSmb74h16HJU65u6yMcbIqS5XVq73yeRQUsavn2I8Qd7UU9bqgep1RfbugjJ_fRS7NiO09_buRDOQe3PQD7v4TVX-8vPi0D_0DR3Siow</recordid><startdate>202502</startdate><enddate>202502</enddate><creator>Diamand, Romain</creator><creator>Bernard, Pierre‐Loup</creator><creator>Mjaess, Georges</creator><creator>Benijts, Jan</creator><creator>Assenmacher, Christophe</creator><creator>Assenmacher, Grégoire</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TO</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8703-4611</orcidid><orcidid>https://orcid.org/0000-0002-2016-8543</orcidid></search><sort><creationdate>202502</creationdate><title>Retzius‐sparing versus standard robot‐assisted laparoscopic prostatectomy: A two‐year patient‐reported and oncological assessment</title><author>Diamand, Romain ; Bernard, Pierre‐Loup ; Mjaess, Georges ; Benijts, Jan ; Assenmacher, Christophe ; Assenmacher, Grégoire</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2827-a9772619a39f3e001ece7b926fa3a199a928f4bd6486eb7f7247154a4dc22fe83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Aged</topic><topic>functional outcomes</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - adverse effects</topic><topic>Laparoscopy - methods</topic><topic>Male</topic><topic>Margins of Excision</topic><topic>Middle Aged</topic><topic>Organ Sparing Treatments - methods</topic><topic>Patient Reported Outcome Measures</topic><topic>Prospective Studies</topic><topic>prostate cancer</topic><topic>Prostatectomy</topic><topic>Prostatectomy - methods</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - surgery</topic><topic>Quality of Life</topic><topic>radical prostatectomy</topic><topic>Retzius‐sparing</topic><topic>Robotic Surgical Procedures - adverse effects</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Surgery</topic><topic>Survival</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Diamand, Romain</creatorcontrib><creatorcontrib>Bernard, Pierre‐Loup</creatorcontrib><creatorcontrib>Mjaess, Georges</creatorcontrib><creatorcontrib>Benijts, Jan</creatorcontrib><creatorcontrib>Assenmacher, Christophe</creatorcontrib><creatorcontrib>Assenmacher, Grégoire</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The Prostate</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Diamand, Romain</au><au>Bernard, Pierre‐Loup</au><au>Mjaess, Georges</au><au>Benijts, Jan</au><au>Assenmacher, Christophe</au><au>Assenmacher, Grégoire</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Retzius‐sparing versus standard robot‐assisted laparoscopic prostatectomy: A two‐year patient‐reported and oncological assessment</atitle><jtitle>The Prostate</jtitle><addtitle>Prostate</addtitle><date>2025-02</date><risdate>2025</risdate><volume>85</volume><issue>2</issue><spage>115</spage><epage>122</epage><pages>115-122</pages><issn>0270-4137</issn><issn>1097-0045</issn><eissn>1097-0045</eissn><abstract>Purpose
To evaluate the two‐year functional and oncological outcomes of Retzius‐sparing robot‐assisted laparoscopic prostatectomy (rsRALP) and standard approach (sRALP).
Methods
A total of 200 consecutive patients who underwent either sRALP (n = 100) or rsRALP (n = 100) for clinically localized PCa at a single referral European center between 2015 and 2020 were identified from a prospectively cohort, as part of the Belgian Cancer Registry. Primary outcomes included functional outcomes and quality of life (QoL) using validated patient‐reported outcome measures (PROMs) assessed at 1‐, 3‐, 12‐, and 24‐months post‐surgery. Secondary outcomes comprised oncological outcomes reported as positive surgical margins (PSM) and 5‐year biochemical recurrence (BCR). Kaplan‐Meier analysis with log‐rank test and multivariable Cox regression were used.
Results
The median follow‐up was 60 months. No significant differences were observed between the surgical approaches in terms of patient and tumor characteristics. Urinary function and QoL were significantly better at each follow‐up period (all p ≤ 0.01) with rsRALP, while sexual function was not significantly different 12 months after surgery. No significant difference in positive surgical margins rate was observed between surgical approaches (31% vs 32%, p = 0.9). Retzius‐sparing RALP was associated with longer PSM lengths (5 mm vs 2.5 mm, p = 0.02), a higher multifocality rate (34% vs. 13%, p < 0.001), more occurrences in organ‐confined disease (59% vs. 39%, p < 0.001) and at anterior locations (37% vs. 16%, p = 0.05). Five‐year BCR‐free survival was not significantly different, and surgical approach was not a predictor of BCR.
Conclusions
The rsRALP approach significantly improves both early and short‐term urinary function and QoL compared to sRALP. Despite being associated with worse PSM characteristics, no significant decrease in BCR‐free survival was observed with rsRALP.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>39380439</pmid><doi>10.1002/pros.24807</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8703-4611</orcidid><orcidid>https://orcid.org/0000-0002-2016-8543</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged functional outcomes Humans Laparoscopy Laparoscopy - adverse effects Laparoscopy - methods Male Margins of Excision Middle Aged Organ Sparing Treatments - methods Patient Reported Outcome Measures Prospective Studies prostate cancer Prostatectomy Prostatectomy - methods Prostatic Neoplasms - pathology Prostatic Neoplasms - surgery Quality of Life radical prostatectomy Retzius‐sparing Robotic Surgical Procedures - adverse effects Robotic Surgical Procedures - methods Surgery Survival Treatment Outcome |
| title | Retzius‐sparing versus standard robot‐assisted laparoscopic prostatectomy: A two‐year patient‐reported and oncological assessment |
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