OBJECTIVE: Older, healthy men with localised prostate cancer are often denied curative surgical treatment on the grounds of worse urinary continence (UC) recovery.
We aimed to compare the recovery of UC after robot-assisted radical prostatectomy (RARP) in men ≥70 years and < 70 years old at 1-year follow-up and assess for preoperative predictors of UC recovery.
PATIENTS AND METHODS: 262 patients having undergone RARP between May 2008 and September 2012 under the care of two consultant urological surgeons at three Melbourne hospitals were identified. Patients were categorised based on their age ≥70 years and < 70 years and compared in regards to two endpoints; percentage fully continent and mean pads per day at 4-6 weeks, 3, 6, 9 and 12 months.
RESULTS: Of 262 men, 9% (n=24) were ≥70 years old. Older men had higher PSA (p=0.007) and clinical stage (p=0.0004) compared to the younger cohort. There were more non-nerve sparing procedures in the older group (p=0.009) and a shorter mean operative time (p=0.004). At 4-6 weeks, the number of pads used per day was greater in older men (p=0.03) and there was a trend towards fewer older men being fully continent (p=0.08) compared to their younger counterparts, however by 3 months and all time points thereafter there was no difference. 12-month continence was 89% and 92% for men < 70 and ≥70 years respectively Neither age, BMI, D'Amico risk group, nerve sparing or use of Rocco suture were predictors of time to urinary continence recovery.
CONCLUSION: Urinary continence recovery after RARP in men ≥70 years appears comparable to young men and therefore not a reason to deny older men with a reasonable life expectancy curative surgical treatment of localised prostate cancer.
Written by:
Basto MY, Vidyasagar C, Te Marvelde L, Freeborn H, Birch E, Landau A, Murphy DG, Moon D. Are you the author?
Peter MacCallum Cancer Centre, Melbourne; Department of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne.
Reference: BJU Int. 2014 May 13. Epub ahead of print.
doi: 10.1111/bju.12800
PubMed Abstract
PMID: 24825396
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