Radical prostatectomy after previous TUR-P: Oncological, surgical, and functional outcomes
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Radical prostatectomy after previous TUR-P: Oncological, surgical, and functional outcomes. / Pompe, Raisa S; Leyh-Bannurah, Sami-Ramzi; Preisser, Felix; Salomon, Georg; Graefen, Markus; Huland, Hartwig; Karakiewicz, Pierre I; Tilki, Derya.
In: UROL ONCOL-SEMIN ORI, Vol. 36, No. 12, 12.2018, p. 527.e21-527.e28.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Radical prostatectomy after previous TUR-P: Oncological, surgical, and functional outcomes
AU - Pompe, Raisa S
AU - Leyh-Bannurah, Sami-Ramzi
AU - Preisser, Felix
AU - Salomon, Georg
AU - Graefen, Markus
AU - Huland, Hartwig
AU - Karakiewicz, Pierre I
AU - Tilki, Derya
N1 - Copyright © 2018. Published by Elsevier Inc.
PY - 2018/12
Y1 - 2018/12
N2 - OBJECTIVES: To examine oncological, surgical, and functional outcomes of radical prostatectomy (RP) in patients with history of transurethral resection of the prostate (TUR-P).MATERIALS AND METHODS: Retrospective analysis of 18,681 RP-patients including 470 patients with previous TUR-P at a single institution (2002-2015). Kaplan-Meier as well as multivariable Cox and logistic regression analyses compared surgical, oncological, and functional outcomes between TUR-P and non-TUR-P patients after propensity score matching (nearest neighbor in a 1:3 fashion).RESULTS: After propensity score adjustment, pathological and surgical results were similar between both groups. Specifically, rates of positive surgical margins and nerve-sparing (NS) procedure did not differ between groups (positive surgical margins: 18.5% vs. 17.2%, P = 0.7; nerve-sparing: 89.4% vs. 91.6%, P = 0.5). In addition, there was no difference in mean operating room time (185 vs. 184 minutes, P = 0.6), blood loss (710 vs. 666 ml, P = 0.1), and catheterization time (12 days, P = 0.3). In multivariable analyses, TUR-P patients did not exhibit higher risk of biochemical recurrence, metastatic progression, or mortality (all P > 0.05). However, TUR-P patients exhibited higher risk for urinary incontinence at third month (OR: 1.47; 95% confidence interval [CI] 1.01-2.12, P = 0.04) and first year (OR: 2.06; 95% CI 1.23-3.42, P = 0.006) and worse 1-year erectile function recovery (OR: 0.48; 95% CI 0.27-0.86, P = 0.02).CONCLUSIONS: This large series of TUR-P RP patients demonstrated that RP could be safely performed in patients with history of TUR-P without compromising oncological results. However, functional outcomes were worse for patients with previous TUR-P.
AB - OBJECTIVES: To examine oncological, surgical, and functional outcomes of radical prostatectomy (RP) in patients with history of transurethral resection of the prostate (TUR-P).MATERIALS AND METHODS: Retrospective analysis of 18,681 RP-patients including 470 patients with previous TUR-P at a single institution (2002-2015). Kaplan-Meier as well as multivariable Cox and logistic regression analyses compared surgical, oncological, and functional outcomes between TUR-P and non-TUR-P patients after propensity score matching (nearest neighbor in a 1:3 fashion).RESULTS: After propensity score adjustment, pathological and surgical results were similar between both groups. Specifically, rates of positive surgical margins and nerve-sparing (NS) procedure did not differ between groups (positive surgical margins: 18.5% vs. 17.2%, P = 0.7; nerve-sparing: 89.4% vs. 91.6%, P = 0.5). In addition, there was no difference in mean operating room time (185 vs. 184 minutes, P = 0.6), blood loss (710 vs. 666 ml, P = 0.1), and catheterization time (12 days, P = 0.3). In multivariable analyses, TUR-P patients did not exhibit higher risk of biochemical recurrence, metastatic progression, or mortality (all P > 0.05). However, TUR-P patients exhibited higher risk for urinary incontinence at third month (OR: 1.47; 95% confidence interval [CI] 1.01-2.12, P = 0.04) and first year (OR: 2.06; 95% CI 1.23-3.42, P = 0.006) and worse 1-year erectile function recovery (OR: 0.48; 95% CI 0.27-0.86, P = 0.02).CONCLUSIONS: This large series of TUR-P RP patients demonstrated that RP could be safely performed in patients with history of TUR-P without compromising oncological results. However, functional outcomes were worse for patients with previous TUR-P.
KW - Journal Article
U2 - 10.1016/j.urolonc.2018.08.010
DO - 10.1016/j.urolonc.2018.08.010
M3 - SCORING: Journal article
C2 - 30442538
VL - 36
SP - 527.e21-527.e28
JO - UROL ONCOL-SEMIN ORI
JF - UROL ONCOL-SEMIN ORI
SN - 1078-1439
IS - 12
ER -