Evidence map›Paper›PMID 42662047›Full record

ArticleBJUI compass2026

Perioperative propranolol during robotic-assisted radical prostatectomy: A randomised, double-blind, placebo-controlled, pilot trial (PeP-RALP).

Shivanthe Sivanesan, Håkon Ramberg, Thomas Kristiansen, Suraj B Thapa, Marthe Bjøre, Viktor Berge, Fredrik Ottosson, Bjørn Brennhovd, Anne M H Storås, Per M Thorsby and 5 more

Abstract read
In one paragraph

Article in BJUI compass, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

15 authors.

Shivanthe SivanesanDepartment of Cancer Surgery The Norwegian Radium Hospital, Oslo University Hospital Oslo Norway.ORCID https://orcid.org/0000-0003-2089-2248
Håkon RambergDepartment of Tumor Biology, Institute of Cancer Research Oslo University Hospital Oslo Norway.
Thomas KristiansenInstitute of Clinical Medicine University of Oslo Oslo Norway.
Suraj B ThapaInstitute of Clinical Medicine University of Oslo Oslo Norway.
Marthe BjøreDepartment of Cancer Surgery The Norwegian Radium Hospital, Oslo University Hospital Oslo Norway.
Viktor BergeDepartment of Cancer Surgery The Norwegian Radium Hospital, Oslo University Hospital Oslo Norway.
Fredrik OttossonDepartment of Cancer Surgery The Norwegian Radium Hospital, Oslo University Hospital Oslo Norway.
Bjørn BrennhovdDepartment of Cancer Surgery The Norwegian Radium Hospital, Oslo University Hospital Oslo Norway.
Anne M H StoråsDepartment of Oncology The Norwegian Radium Hospital, Oslo University Hospital Oslo Norway.ORCID https://orcid.org/0000-0002-9376-9163
Per M ThorsbyInstitute of Clinical Medicine University of Oslo Oslo Norway.
Sandra R DahlHormone Laboratory, Department of Medical Biochemistry and Endocrinology and Metabolism Research Group Oslo University Hospital Oslo Norway.
Alfonso UrbanucciDepartment of Tumor Biology, Institute of Cancer Research Oslo University Hospital Oslo Norway.
Helene Hartvedt GrytliDepartment of Tumor Biology, Institute of Cancer Research Oslo University Hospital Oslo Norway.
Lars BjerkeProstatakreftforeningen (PROFO) Oslo Norway.
Kristin Austlid TaskénDepartment of Tumor Biology, Institute of Cancer Research Oslo University Hospital Oslo Norway.ORCID https://orcid.org/0000-0001-5530-4915

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: This study aimed to determine the feasibility and safety of administering perioperative propranolol, as an adjunct to reduce prostate cancer recurrence, in patients undergoing robotic-assisted laparoscopic prostatectomy (RALP) for European Association of Urology (EAU) intermediate- or high-risk prostate cancer. Patients and methods: Treatment-naïve men aged 40-80 years with EAU intermediate- or high-risk prostate cancer scheduled for RALP were enrolled in this single-centre, randomised, double-blind, placebo-controlled, phase 2 pilot trial. Participants were randomised 1:1 to receive propranolol or placebo for approximately 3 weeks (about 1 week pre-RALP and 2 weeks post-RALP). Serial blood sampling was performed to measure catecholamine metabolites, serum propranolol and short-interval prostate-specific antigen (PSA) dynamics. Participants self-monitored pulse rate and blood pressure twice daily. Results: Over 36 weeks in 2023, 160 patients underwent RALP; 111 were prescreened, 49 were fully screened and 40 were randomised, corresponding to inclusion rates of 36% among prescreened and 82% among fully screened patients. Pre-RALP adherence was 98% in both arms; post-RALP adherence was lower in the propranolol arm. No Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 grade ≥3 adverse events were attributed to propranolol, and no surgeries were delayed. The epinephrine metabolite metanephrine increased intraoperatively in both arms and declined by the end of treatment. Mean preoperative PSA decreased more with propranolol than with placebo. As this pilot was not powered to detect between-group differences, such differences are hypothesis-generating only. Conclusions: PeP-RALP demonstrated that perioperative propranolol is operationally feasible and demonstrated an acceptable safety profile within RALP workflows, with strong preoperative adherence. Our study supports a multicentre efficacy randomised controlled trial with standardised anaesthetic protocols, postoperative adherence support and oncological endpoints. All physiological and molecular results, including PSA dynamics, in this pilot are exploratory and solely intended to inform the design of any future trials.

Indexed as

feasibility trialperioperative propranololprostate cancerradical prostatectomysurgical stress

Identifiers

PMID42662047
PMCPMC13519088

What OpenQuestion holds

Textmetadata
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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.