Pioneering robotic-assisted laparoscopic prostatectomy in a regional UK centre: first 100 cases with a minimum 12 months’ follow-up

Abstract

Objective:

Robotic-assisted laparoscopic prostatectomy (RALP) has become an increasingly popular choice of treatment for prostate cancer, but there is a paucity of published outcome data in the UK. We aim to assess the safety and feasibility of RALP at a regional UK hospital.

Methods:

The first 100 cases of RALP performed by four surgeons at our institution were analysed. Demographic, clinical, surgical, pathological and outcome data were collected with a minimum of 12 months’ follow up.

Results:

The mean age of the patients was 60.7 years. The D’Amico risk stratifications were 41% low risk, 55% intermediate risk and 4% high risk. The median operating time was 245 min (150–522 min) and the median blood loss was 200ml (50–1800ml). Eighty-four per cent were pathological T1/T2; 16% were T3/T4. The positive margin rate was 22% with T3/T4 disease the dominant risk factor (p<0.05). The stage specific positive margin rate was 16.7% for T1/T2 and 50.0% for T3/T4 disease. At 12-month follow-up the pad free continence rate was 82.0%. The 0–1 pad rate was 96%. The 12-month potency rates were 62.8% for bilateral nerve spare and 31.8% for unilateral nerve spare procedures. Two patients experienced biochemical recurrence at six and 18 months, respectively.

Conclusion:

RALP is a safe and feasible procedure at a regional non-teaching hospital.