Impact of NeuroSAFE on Long-Term Outcomes in Robot-Assisted Prostatectomy

What is it about?

In this study, the authors compare the 1-year functional and 5-year oncological outcomes of men undergoing robot-assisted laparoscopic prostatectomy (RALP) with neurovascular structure-adjacent frozen-section examination (NeuroSAFE) with those in men undergoing RALP without NeuroSAFE (standard of care [SOC]). The results show that NeuroSAFE patients had equivalent time to biochemical recurrence (BCR) and risk of 1-year incontinence, and significantly lower risk of 1-year erectile dysfunction compared to SOC. NeuroSAFE approach relies on the principle that more aggressive dissection can be safely mitigated by intra-operative frozen section, leading to improved potency outcomes without compromising long-term oncological outcomes. The findings should encourage urologists to consider intra-operative frozen section in their practice to improve postoperative potency for their patients.

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Why is it important?

This research is important because it compares the functional and oncological outcomes of men undergoing robot-assisted laparoscopic prostatectomy (RALP) with neurovascular structure-adjacent frozen-section examination (NeuroSAFE) to those who undergo RALP without NeuroSAFE (standard of care [SOC]). The study found that the NeuroSAFE approach did not compromise long-term oncological outcomes but improved potency outcomes without increasing the risk of erectile dysfunction. This finding is significant as it could encourage urologists to consider intra-operative frozen section in their practice to improve postoperative potency for their patients. Key Takeaways: 1. Men undergoing RALP with NeuroSAFE had equivalent time to biochemical recurrence (BCR) and risk of 1-year incontinence compared to those undergoing RALP without NeuroSAFE (standard of care [SOC]). 2. NeuroSAFE patients had significantly lower risk of 1-year erectile dysfunction compared to SOC patients. 3. NeuroSAFE approach does not compromise long-term oncological outcomes but improves potency outcomes. 4. This study could encourage urologists to consider intra-operative frozen section in their practice to improve postoperative potency for their patients.