Evidence map›Paper›PMID 34562303›Full record

ArticleCancer medicine2021

Extended robot-assisted laparoscopic prostatectomy and extended pelvic lymph node dissection as a monotherapy in patients with very high-risk prostate cancer Patients.

Noriyoshi Miura, Naoya Sugihara, Keisuke Funaki, Toshio Kakuda, Kanae Koyama, Ryuta Watanabe, Yuichiro Sawada, Terutaka Noda, Kenichi Nishimura, Tetsuya Fukumoto and 3 more

Open access · goldAbstract read
In one paragraph

Article in Cancer medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Noriyoshi MiuraDepartment of Urology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.ORCID 0000-0002-2229-0948
Naoya SugiharaDepartment of Urology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Keisuke FunakiDepartment of Urology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Toshio KakudaDepartment of Urology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Kanae KoyamaDepartment of Urology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Ryuta WatanabeDepartment of Urology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Yuichiro SawadaDepartment of Urology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Terutaka NodaDepartment of Urology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Kenichi NishimuraDepartment of Urology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Tetsuya FukumotoDepartment of Urology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Yuki MiyauchiDepartment of Urology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Tadahiko KikugawaDepartment of Urology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Takashi SaikaDepartment of Urology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Ehime University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with very-high-risk prostate cancer (VHRPCa) have earlier biochemical recurrences (BCRs) and higher mortality rates. It remains unknown whether extended robot-assisted laparoscopic prostatectomy (eRALP) without neoadjuvant or adjuvant therapy can improve the outcomes of VHRPCa patients. We aimed to determine the feasibility and efficacy of eRALP as a form of monotherapy for VHRPCa.

methodsData from 76 men who were treated with eRALP without neoadjuvant/adjuvant therapy were analyzed. eRALP was performed using an extrafascial approach. Extended pelvic lymph node (LN) dissection (ePLND) included nodes above the external iliac axis, in the obturator fossa, and around the internal iliac artery up to the ureter. The outcome measures were BCR, treatment failure (defined as when the prostate-specific antigen level did not decrease to <0.1 ng/ml postoperatively), and urinary continence (UC). Kaplan-Meier, logistic regression, and Cox proportional-hazards model were used to analyze the data.

resultsThe median operative time was 246 min, and median blood loss was 50 ml. Twenty-one patients experienced postoperative complications. Median follow-up was 25.2 months; 19.7% of patients had treatment failure. Three-year, BCR-free survival rate was 62.0%. Castration-resistant prostate cancer-free survival rate was 86.1%. Overall survival was 100%. In 55 patients who had complete postoperative UC data, 47 patients (85.5%) recovered from their UC within 12 months. Clinical stage cT3b was an independent preoperative treatment failure predictor (p = 0.035), and node positivity was an independent BCR predictor (p = 0.037). The small sample size and retrospective nature limited the study.

conclusionsThis approach was safe and produced acceptable UC-recovery rates. Preoperative seminal vesicle invasion is associated with treatment failure, and pathological LN metastases are associated with BCR. Therefore, our results may help informed decisions about neoadjuvant or adjuvant therapies in VHRPCa cases. PRECIS: Extended robot-assisted laparoscopic prostatectomy and extended pelvic lymph node dissection without adjuvant therapy is safe and effective for some patients with very-high-risk prostate cancer. The clinical stage and node positivity status predicted monotherapy failure, which may indicate good adjuvant therapy candidate.

Indexed as

AgedHumansLaparoscopyLymph Node ExcisionMalePelvisProstatectomyProstatic NeoplasmsRetrospective StudiesRisk FactorsRoboticsSurvival Analysisextended pelvic lymph node dissectionextended robot-assisted laparoscopic prostatectomylocally advanceprostate cancervery-high risk

Identifiers

PMID34562303
PMCPMC8607267
OpenAlexW3199091378

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.