Pentafecta: A New Concept for Reporting Outcomes of Robot-Assisted Laparoscopic Radical Prostatectomy

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorPATEL, Vipul R.
dc.contributor.authorSIVARAMAN, Ananthakrishnan
dc.contributor.authorCOELHO, Rafael F.
dc.contributor.authorCHAUHAN, Sanket
dc.contributor.authorPALMER, Kenneth J.
dc.contributor.authorORVIETO, Marcelo A.
dc.contributor.authorCAMACHO, Ignacio
dc.contributor.authorCOUGHLIN, Geoff
dc.contributor.authorROCCO, Bernardo
dc.date.accessioned2017-11-27T16:38:04Z
dc.date.available2017-11-27T16:38:04Z
dc.date.issued2011
dc.description.abstractBackground: Widespread use of prostate-specific antigen screening has resulted in younger and healthier men being diagnosed with prostate cancer. Their demands and expectations of surgical intervention are much higher and cannot be adequately addressed with the classic trifecta outcome measures. Objective: A new and more comprehensive method for reporting outcomes after radical prostatectomy, the pentafecta, is proposed. Design, setting, and participants: From January 2008 through September 2009, details of 1111 consecutive patients who underwent robot-assisted radical prostatectomy performed by a single surgeon were retrospectively analyzed. Of 626 potent men, 332 who underwent bilateral nerve sparing and who had 1 yr of follow-up were included in the study group. Measurements: In addition to the traditional trifecta outcomes, two perioperative variables were included in the pentafecta: no postoperative complications and negative surgical margins. Patients who attained the trifecta and concurrently the two additional outcomes were considered as having achieved the pentafecta. A logistic regression model was created to evaluate independent factors for achieving the pentafecta. Results and limitations: Continence, potency, biochemical recurrence-free survival, and trifecta rates at 12 mo were 96.4%, 89.8%, 96.4%, and 83.1%, respectively. With regard to the perioperative outcomes, 93.4% had no postoperative complication and 90.7% had negative surgical margins. The pentafecta rate at 12 mo was 70.8%. On multivariable analysis, patient age (p = 0.001) was confirmed as the only factor independently associated with the pentafecta. Conclusions: A more comprehensive approach for reporting prostate surgery outcomes, the pentafecta, is being proposed. We believe that pentafecta outcomes more accurately represent patients' expectations after minimally invasive surgery for prostate cancer. This approach may be beneficial and may be used when counseling patients with clinically localized disease.
dc.description.indexMEDLINE
dc.identifier.citationEUROPEAN UROLOGY, v.59, n.5, p.702-707, 2011
dc.identifier.doi10.1016/j.eururo.2011.01.032
dc.identifier.issn0302-2838
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/23598
dc.language.isoeng
dc.publisherELSEVIER SCIENCE BV
dc.relation.ispartofEuropean Urology
dc.rightsrestrictedAccess
dc.rights.holderCopyright ELSEVIER SCIENCE BV
dc.subjectMinimally invasisve
dc.subjectRobot assisted
dc.subjectRadical prostatectomy
dc.subjectOutcomes
dc.subjectTrifecta
dc.subjectPentafecta
dc.subjectCounseling tool
dc.subject.othercancer
dc.subject.othervalidation
dc.subject.otherquality
dc.subject.otherindex
dc.subject.othermen
dc.subject.wosUrology & Nephrology
dc.titlePentafecta: A New Concept for Reporting Outcomes of Robot-Assisted Laparoscopic Radical Prostatectomy
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryItália
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryisous
hcfmusp.affiliation.countryisoit
hcfmusp.author.externalPATEL, Vipul R.:Univ Cent Florida, Global Robot Inst, Florida Hosp Celebrat Hlth, Coll Med,Sch Med, Celebration, FL 34747 USA
hcfmusp.author.externalROCCO, Bernardo:Univ Milan, Ist Urol, Osped Policlin Fdn Ca Granda, Milan, Italy
hcfmusp.citation.scopus270
hcfmusp.contributor.author-fmusphcRAFAEL FERREIRA COELHO
hcfmusp.description.beginpage702
hcfmusp.description.endpage707
hcfmusp.description.issue5
hcfmusp.description.volume59
hcfmusp.origemWOS
hcfmusp.origem.pubmed21296482
hcfmusp.origem.scopus2-s2.0-79953252756
hcfmusp.origem.wosWOS:000288991500010
hcfmusp.publisher.cityAMSTERDAM
hcfmusp.publisher.countryNETHERLANDS
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