What is it about?

A prospective cohort study comparing peri-and postoperative outcomes for patients with predominantly anterior prostate cancer (APC) identified preoperatively against non-anterior prostate cancer (NAPC) treated via robotic-assisted radical prostatectomy (RARP) found that APCs had significantly lower ISUP grading postoperatively, increased diagnosis via active surveillance over new diagnosis, more frequently undertaken bilateral nerve-sparing and long-term poorer continence outcomes at 18 and 24 months postoperatively. Pre-and post-op PSA levels, erectile function, PSA density, positive surgical margins (PSM), age and tumour staging showed no significant differences between the APC and NAPC cohorts. The lower ISUP grading could indicate APC as overall being less aggressive than NAPC, whereas the poorer long-term continence outcomes require further investigating. Overall, this study provides useful information on the growing literature of anterior prostate cancer and helps improve education, patient expectations and management.

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Why is it important?

This research is important because it provides useful information on the characteristics and outcomes of anterior prostate cancer, which is often underrepresented in studies. The study is the largest comparative cohort study to date on anterior prostate cancer post-RARP, and its results can help improve education, patient expectations, and management of the disease. The findings highlight the need for further investigating the poorer long-term continence outcomes for anterior prostate cancer patients and the potential inadequacies in the current diagnostic techniques. Key Takeaways: 1. Anterior prostate cancer is less aggressive than non-anterior prostate cancer, as indicated by the lower ISUP grading postoperatively. 2. Anterior prostate cancer is more frequently diagnosed via active surveillance, which may suggest some inadequacies in the current diagnostic techniques. 3. Anterior prostate cancer patients have poorer long-term continence outcomes compared to non-anterior prostate cancer patients, which requires further investigation. 4. There were no significant differences in preoperative PSA levels, tumor staging, PSA density, positive surgical margins, or erectile function outcomes between the anterior and non-anterior cohorts.

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This page is a summary of: Clinical outcomes of anterior prostate cancers treated with robotic assisted radical prostatectomy, BJUI Compass, October 2022, Wiley,
DOI: 10.1002/bco2.202.
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