Introduction and objective
To evaluate the impact of focal therapy on functional and oncological outcomesfollowing RARP.
Methods
53 patients who had prostatectomy following the failure of focal ablation were selected and labeled group I. The patients who had whole gland ablation and external beam therapy were excluded. They were then compared to a matched control sample of the ratio of 1:1, 1:2, 1:3 with the RARP cohort. Age, PSA, PSA density, BMI, SHIM, AUA, Charlson Comorbidity Index, Prostate weight, Preoperative Gleason score, and history of Smoking were used to perform matching. The oncological and functional outcomes between these groups were compared.SRARP following focal therapy was performed in all cases using a standardized technique developed at our institute with the da Vinci Xi Surgical System.
Results
No difference in EBL and OR time was noted between the focal and control group. More full NS was performed in the control group compared to the focal group. The focal therapy group had a higher incidence of the positive surgical margin. Also, the focal therapy group had a higher incidence of GS >=8 and positive lymph node status. The focal therapy group had a higher incidence of lymphocele drainage post-surgery.
Conclusions
Salvage robotic-assisted radical prostatectomy after focal therapy failure is feasiblehowever, surgery following focal therapy leads to poorer oncological and functional outcomes.Despite the targeted nature of FT, significant non-focal collateral damage is seen to tissuessurrounding the prostate, which in turn translates to poorer functional outcomes post salvageRARP.
Source of funding
None