Mp52-12 Association Between Age and Major Complications After Robotic Assisted Radical Prostatectomy: A Multi-Institutional Series

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy II (MP52)1 May 2024MP52-12 ASSOCIATION BETWEEN AGE AND MAJOR COMPLICATIONS AFTER ROBOTIC ASSISTED RADICAL PROSTATECTOMY: A MULTI-INSTITUTIONAL SERIES Alec Zhu, Amy L. Tin, Andrew J. Vickers, Keith Kowalczyk, Behfar Ehdaie, Belen Mora, Sofia Gereta, and Jim C. Hu Alec ZhuAlec Zhu , Amy L. TinAmy L. Tin , Andrew J. VickersAndrew J. Vickers , Keith KowalczykKeith Kowalczyk , Behfar EhdaieBehfar Ehdaie , Belen MoraBelen Mora , Sofia GeretaSofia Gereta , and Jim C. HuJim C. Hu View All Author Informationhttps://doi.org/10.1097/01.JU.0001008864.84854.b7.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Traditionally, older patients were at greater risk for perioperative complications with open radical prostatectomy, and radiotherapy was preferred. However, contemporary outcomes after robotic-assisted radical prostatectomies (RARP) are unknown. We conducted a multi-center study to examine the association between age and RARP complications. METHODS: We pooled outcomes from Weill Cornell (n=558), Medstar Georgetown (n=320), and Memorial Sloan Kettering (n=6,632) for patients undergoing RARP during 2012-2022. Our primary outcome was any major complication (Clavien-Dindo grade ≥3) within 30 days of surgery. We used multivariable logistic regression, adjusting for surgeon volume and oncologic risk using a postoperative nomogram (which included pre-operative PSA, RARP Gleason Grade Group, extracapsular extension, seminal vesical invasion, lymph node involvement, and surgical margin status), to assess the association between continuous age and major complications. Using a meta-analytic approach, we also tested for heterogeneity in the association between age and risk of complication between the three institutions. RESULTS: A total of 7,540 patients were treated across the three institutions. Unadjusted rates of major complications were 2.2%, 4.1%, and 2.0% at Cornell, Georgetown, and MSKCC, respectively. Increasing age was significantly associated with increased risk of complications (adjusted OR 1.03, 95% CI 1.00-1.05, p=0.022). For the average patient (with all covariates in the model set to the mean), the estimated risk of major complication for a 50-, 60-, and 70-year-old is 1.5% (95% CI 1.1-2.2), 2.0% (95% CI 1.7-2.4), and 2.6% (95% CI 2.1-3.2), respectively (Figure 1). No evidence of heterogeneity in the association between age and complications was found based on institution (test for heterogeneity p>0.9). CONCLUSIONS: Risks of RARP complications were low even for the oldest patients. Although older age is associated with a statistically significant increase in the risk of complications, the effect is minimal and not clinically significant within our well-selected patient population. Thus, when counseling patients regarding prostate cancer treatment options, older age should not be a contraindication to RARP. Download PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e857 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Alec Zhu More articles by this author Amy L. Tin More articles by this author Andrew J. Vickers More articles by this author Keith Kowalczyk More articles by this author Behfar Ehdaie More articles by this author Belen Mora More articles by this author Sofia Gereta More articles by this author Jim C. Hu More articles by this author Expand All Advertisement PDF downloadLoading ...