Oncologic outcomes with and without amniotic membranes in robotic-assisted radical prostatectomy:A propensity score matched analysis  

作　　者：Jonathan Noël Daniel Stirt Marcio Covas Moschovas Sunil Reddy Abdel Rahman Jaber Marco Sandri Seetharam Bhat Travis Rogers Subuhee Ahmed Anya Mascarenhas Ela Patel Vipul Patel 

机构地区：[1]Advent Health Global Robotics Institute,Celebration,FL,USA [2]University of Central Florida College of Medicine,Orlando,FL,USA [3]Big and Open Data Innovation Laboratory,University of Brescia,Italy [4]SUNY Upstate Medical University,Syracuse,NY,USA [5]Kansas City University College of Medicine,Kansas City,MO,USA [6]Harvard University,Cambridge,MA,USA

出　　处：《Asian Journal of Urology》2024年第1期19-25,共7页亚洲泌尿外科杂志（英文）

摘　　要：Objective:Placement of human placenta derived grafts during robotic-assisted radical prostatectomy(RARP)hastens the return of continence and potency.The long-term impact on the oncologic outcomes remains to be investigated.Our objective was to determine the oncologic outcomes of patients with dehydrated human amnion chorion membrane(dHACM)at RARP compared to a matched cohort.Methods:In a referral centre,from August 2013 to October 2019,599 patients used dHACM in bilateral nerve-sparing RARP.We excluded patients with less than 12 months follow-up,simple prostatectomy,and unilateral nerve-sparing.Patients with dHACM(amnio group)were 529,and were propensity score matched 1:1 to 2465 patients without dHACM(non-amnio group)and a minimum follow-up of 36 months.At the time of RARP,dHACM was placed around the neurovascular bundle in the amnio group.Continuous and categorical variables in matched groups was tested by two-sample Kolmogorov-Smirnov test and Fisher's exact test respectively.Outcomes measured were biochemical recurrence(BCR),adjuvant and salvage therapy rates.Results:Propensity score matching resulted in two groups of 444 patients.Cumulative incidence functions for BCR did not show a difference between the groups(p=0.3).Patients in the non-amnio group required salvage therapy more frequently than the amnio group,particularly after partial nerve-sparing RARP(6.3%vs.2.3%,p=0.001).Limitations are the absence of prospective randomization.Conclusion:The data suggest that using dHACM does not have a negative impact on BCR in patients.Outcomes of cancer specific and overall survival will require follow-up study to increase our understanding of these grafts’impact on prostate cancer biology.

关 键 词：Prostatectomy Prostatecancer Robotic ONCOLOGY OUTCOME ALLOGRAFT Biomaterial Dehydrated human amnionchorion membrane 

分 类 号：R699[医药卫生—泌尿科学]