Background:

Twenty to 30% of prostate cancer patients present with high-risk disease. Treatment is controversial and the trend today is toward multimodal management, with radical prostatectomy as the initial step.

Objective:

To report the results of robotic-assisted radical prostatectomy in patients with high-risk localized prostate cancer.

Materials and methods:

A retrospective, descriptive, observational, and longitudinal study was conducted on patients with at least one high-risk criterion (prostate-specific antigen ≥ 20 ng/mL, clinical stage ≥ T2c and/or Gleason score ≥ 8) that underwent robotic-assisted radical prostatectomy. Preoperative and perioperative variables were evaluated, along with the oncologic and functional follow-up data, and measures of central tendency were used for the statistical analysis with the SPSS program.

Results:

Of the 128 case records retrieved, 21 of those patients met at least one high-risk criterion. The most common criterion was a Gleason score > 8 (52.4%). Mean patient age was 68.9 years; prostate-specific antigen, 19 ng/mL; surgery duration, 300.2 min; blood loss, 494.8 mL; and transfusion rate, 4.8%. The complication rate was 33%; hospital stay, 6.9 days; time with catheter, 13.9 days; positive surgical margins, 47.6%; biochemical recurrence, 28.6%; adjuvant therapy, 38.1%; and preserved continence and erectile function were 58.8 and 47%, respectively, at month 12 of follow-up.

Conclusions:

Robotic-assisted radical prostatectomy is a safe, minimally invasive procedure, with low morbidity and satisfactory perioperative and functional results. Additional studies and long-term follow-up are required.