• Cristina Cano Garcia, Mike Wenzel, Florestan Koll, Agnes Zatik, Jens Köllermann, Markus Graefen, Derya Tilki, Pierre I Karakiewicz, Luis A Kluth, ChunFelix K HFKHGoethe University Frankfurt, University Hospital Frankfurt, Department of Urology, Germany., Philipp Mandel, and Benedikt Hoeh.
• Goethe University Frankfurt, University Hospital Frankfurt, Department of Urology, Germany; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. Electronic address: cristina.canogarcia@kgu.de.
• Clinics (Sao Paulo). 2023 Jan 1; 78: 100284100284.

ObjectivesWithin the tertiary-case database, the authors tested for differences in long-term continence rates (≥ 12 months) between prostate cancer patients with extraprostatic vs. organ-confined disease who underwent Robotic-Assisted Radical Prostatectomy (RARP).MethodIn the institutional tertiary-care database the authors identified prostate cancer patients who underwent RARP between 01/2014 and 01/2021. The cohort was divided into two groups based on tumor extension in the final RARP specimen: patients with extraprostatic (pT3/4) vs. organ-confined (pT2) disease. Additionally, the authors conducted subgroup analyses within both the extraprostatic and organ-confined disease groups to compare continence rates before and after the implementation of the new surgical technique, which included Full Functional-Length Urethra preservation (FFLU) and Neurovascular Structure-Adjacent Frozen-Section Examination (NeuroSAFE). Multivariable logistic regression models addressing long-term continence were used.ResultsOverall, the authors identified 201 study patients of whom 75 (37 %) exhibited extraprostatic and 126 (63 %) organ-confined disease. There was no significant difference in long-term continence rates between patients with extraprostatic and organ-confined disease (77 vs. 83 %; p = 0.3). Following the implementation of FFLU+ NeuroSAFE, there was an overall improvement in continence from 67 % to 89 % (Δ = 22 %; p < 0.001). No difference in the magnitude of improved continence rates between extraprostatic vs. organ-confined disease was observed (Δ = 22 % vs. Δ = 20 %). In multivariable logistic regression models, no difference between extraprostatic vs. organ-confined disease in long-term continence was observed (Odds Ratio: 0.91; p = 0.85).ConclusionIn this tertiary-based institutional study, patients with extraprostatic and organ-confined prostate cancer exhibited comparable long-term continence rates.Copyright © 2023 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.

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