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Background <p>To investigate the efficacy and safety of robot-assisted radical prostatectomy (RARP) combined with extended pelvic lymph node dissection (ePLND) and immediate androgen deprivation therapy (ADT) for patients with locally advanced or lymph node metastatic prostate cancer (pT3-4N0-1M0).</p> Methods <p>We retrospectively analyzed clinical data from 40 patients with pT3-4N0-1M0 prostate cancer treated between April 2021 and April 2024. All patients had preoperative PSA &gt; 20 ng/mL and received RARP + ePLND followed by immediate ADT. Postoperative follow-up ranged from 12 to 48 months, with records of surgical parameters, complications, urinary continence recovery, and biochemical recurrence.</p> Results <p>Operative time (207.4 ± 70.7&#xa0;min), intraoperative blood loss (111.7 ± 127.8 mL), positive surgical margin rate (17.5%), and overall complication rate (10.0%) were all within acceptable ranges. Median postoperative hospitalization and catheter indwelling times were 7 and 22 days, respectively. Urinary continence recovery rates at 1, 3, 6, and 12 months were 62.5%, 85.0%, 90.0%, and 95.0%. During follow-up, one patient with positive margins (R1) and positive lymph nodes (N1) experienced biochemical recurrence at 3 years postoperatively, while one R1 but node-negative (N0) patient recurred at 4 years.</p> Conclusions <p>RARP + ePLND combined with immediate ADT is safe and feasible for treating locally advanced or lymph node metastatic prostate cancer (pT3-4N0-1M0), providing patients with favorable functional recovery and oncological outcomes.</p> Trial registration <p>Not applicable. (This study is a retrospective analysis and was not registered in a clinical trials registry.)</p>

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Outcomes of robotic prostatectomy with lymph node removal and early hormone therapy for locally advanced prostate cancer (pT3-4N0-1M0)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月18日

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  • Yi Yang,
  • Jianli Cheng,
  • Xinhui Liao,
  • Jieqing Chen,
  • Jianting Wu,
  • Chenglong Wu,
  • Yuhan Liu,
  • Xiaohong Han,
  • Hongbing Mei

摘要

Background

To investigate the efficacy and safety of robot-assisted radical prostatectomy (RARP) combined with extended pelvic lymph node dissection (ePLND) and immediate androgen deprivation therapy (ADT) for patients with locally advanced or lymph node metastatic prostate cancer (pT3-4N0-1M0).

Methods

We retrospectively analyzed clinical data from 40 patients with pT3-4N0-1M0 prostate cancer treated between April 2021 and April 2024. All patients had preoperative PSA > 20 ng/mL and received RARP + ePLND followed by immediate ADT. Postoperative follow-up ranged from 12 to 48 months, with records of surgical parameters, complications, urinary continence recovery, and biochemical recurrence.

Results

Operative time (207.4 ± 70.7 min), intraoperative blood loss (111.7 ± 127.8 mL), positive surgical margin rate (17.5%), and overall complication rate (10.0%) were all within acceptable ranges. Median postoperative hospitalization and catheter indwelling times were 7 and 22 days, respectively. Urinary continence recovery rates at 1, 3, 6, and 12 months were 62.5%, 85.0%, 90.0%, and 95.0%. During follow-up, one patient with positive margins (R1) and positive lymph nodes (N1) experienced biochemical recurrence at 3 years postoperatively, while one R1 but node-negative (N0) patient recurred at 4 years.

Conclusions

RARP + ePLND combined with immediate ADT is safe and feasible for treating locally advanced or lymph node metastatic prostate cancer (pT3-4N0-1M0), providing patients with favorable functional recovery and oncological outcomes.

Trial registration

Not applicable. (This study is a retrospective analysis and was not registered in a clinical trials registry.)