Robot-assisted radical prostatectomy in men aged ≥70 years

OBJECTIVES To assess the outcomes of elderly men with prostate cancer treated with robot-assisted radical prostatectomy (RARP), because more healthy elderly men will present with localized prostate cancer and many will seek surgical treatment as the population ages. PATIENTS AND METHODS Between 2005 and 2008, 203 men had RARP performed by one surgeon; patients were categorized into two groups based on their age (≥70 vs <70 years). All data were recorded prospectively in an institutional approved database. RESULTS Of the 203 men, 23 (11%) were aged ≥70 years; the older men had similar baseline characteristics as younger men, and had characteristics during and after surgery comparable to those in younger men. The pathological RARP Gleason grade was significantly greater in older men. Surgical complications were not significantly different between the groups. Continence rates were significantly lower in older men at 6 months after surgery, but returned to levels equivalent to those in younger men within 12 months after surgery. Older patients took significantly longer to be capable of driving after surgery. CONCLUSIONS The outcomes of RARP in elderly men are largely comparable to those in younger men, with the exception of higher pathological Gleason grade, a transient delay in return of continence, and taking longer to return to driving after surgery. Advanced chronological age should not be a contraindication for RARP in patients with clinically localized prostate cancer, but expectations should be managed preoperatively.