The available randomised controlled trials (RCTs) assessing the influence of peritoneal interposition flaps (PIF) on the reduction of symptomatic lymphoceles (sLCs) post robot-assisted radical prostatectomy (RARP) do not constitute a sufficient follow-up (FU) to assess the long-term effects. The PIANOFORTE trial was the first of these RCTs, showing no sLC reduction at the 3-month FU. Therefore, all 232 patients from the PIANOFORTE trial were invited for long-term FU. One hundred seventy-six patients (76%) presented themselves for FU and constituted the study group (SG). The median FU duration was 43 months. No significant differences in group allocation or LC endpoints at 90 days were observed between SG patients and patients not presenting themselves for the FU. During the FU period, four patients (2.3%) in the SG developed sLCs, and six patients (3.4%) developed asymptomatic lymphoceles (aLCs), which persisted in five patients (2.9%). There were no significant differences between PIF and non-PIF regarding sLC/aLC formation or persistence, newly developed complications, stress urinary incontinence or biochemical/clinical tumour recurrence. Therefore, this long-term FU confirms the primary outcomes of the PIANOFORTE trial that, while PIF does not impact complications or functionality, it does not reduce sLC/aLC rates. Furthermore, it shows the potential occurrence of LC after the third postoperative month.
Cancers. 2024 May 19*** epublish ***
Christopher Goßler, Matthias May, Steffen Weikert, Sebastian Lenart, Anton Ponholzer, Christina Dreissig, Gjoko Stojanoski, Isabel Anzinger, Josef Riester, Maximilian Burger, Christian Gilfrich, Roman Mayr, Johannes Bründl
Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, 93053 Regensburg, Germany., Department of Urology, St. Elisabeth Hospital Straubing, Brothers of Mercy Hospital, 94315 Straubing, Germany., Department of Urology, Alexianer Hospital St. Hedwig, 10115 Berlin, Germany., Department of Urology and Andrology, St. John of God Hospital Vienna, Brothers of Mercy Hospital, 1020 Vienna, Austria., Department of Urology, Varisano Hospital Frankfurt Höchst, 65929 Frankfurt am Main, Germany., Department of Urology, Mallersdorf Hospital, 84066 Mallersdorf, Germany.