Evaluation of pentafecta in patients with high and very high risk prostate cancer: comparison between laparoscopic radical prostatectomy and open prostatectomy
DOI:
https://doi.org/10.48193/rjz6ss85Keywords:
Prostate cancer, high-risk, pentafecta, open prostatectomy, laparoscopic prostatectomyAbstract
Introduction: prostate cancer (PCa) is the most frequently diagnosed malignancy in men worldwide. Approximately 15 % of cases present as high or very high risk, for which the optimal surgical approach remains controversial. The pentafecta has been proposed as a key indicator of surgical success, integrating oncological and functional outcomes. This study aimed to compare 12-month pentafecta outcomes between open radical prostatectomy (ORP) and laparoscopic radical prostatectomy (LRP) in patients with high and very high-risk PCa.
Material and methods: a retrospective observational study was conducted from 2021 to 2024, including 25 patients with localized high or very high-risk PCa who underwent ORP or LRP with extended pelvic lymphadenectomy. Clinical, pathological, and functional variables were analyzed. Comparisons were made using Chi-square, Student’s t-test, or Mann-Whitney U test, according to data distribution. A p-value < 0.05 was considered statistically significant.
Results: of the 25 patients, 12 underwent ORP and 13 underwent LRP. The overall pentafecta rate was 36 %. ORP showed a higher rate (50 %) compared to LRP (23 %) (p=0.061). ORP was associated with better biochemical control (p=0.023), fewer perioperative complications (p=0.054), and better erectile function outcomes (p=0.005). Urinary continence rates were similar between groups (p=0.317).
Conclusions: we did not find statistically significant differences in the global pentafecta evaluation; however, the ORP showed important clinical differences in comparison to LRP.
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