title: Safety and Efficacy of Robot-assisted Radical Prostatectomy in a Low-volume Center: A 6-year Single-surgeon Experience.
abstract: OBJECTIVE
  To analyze safety and efficacy of robot-assisted radical prostatectomy (RARP) in a low-volume centre.
  
  
  METHODS
  From 2008 to 2015, 400 consecutive patients undergoing RARP were prospectively enrolled. Complications were classified according to the Modified Clavien System. Biochemical recurrence (BCR) was defined as two consecutive prostate-specific antigen (PSA) values ≥0.2 ng/ml. Functional outcomess were assessed using validated, self-administered questionnaires.
  
  
  RESULTS
  Median patient age was 64.5 years. Mean standard deviation (SD) preoperative PSA level was 11.3 (11.7) ng/ml. Median interquartile range (IQR) follow-up was 36 (12-48) months. Overall complication rate was 27.7% (minor complications rate 16.2%). Overall 1-, 3- and 6-year BCR-free survival rates were 85.7%, 77.5% and 53.9%, respectively; these rates were 94.1%, 86.2% and 70.1% in pT2 diseases. At follow-up, 98.4% of patients were fully continent (median (IQR) time to continence was 2 (1-3) months) and 68.2% were potent (median (IQR) time to potency of 3 (3-4) months).
  
  
  CONCLUSIONS
  RARP appears to be a valuable option for treating clinically localised prostate cancer also in a low-volume institution.
authors.affiliation: Department of Urology, Lucerne Cantonal Hospital, Lucerne, Switzerland Deptartment of Obstetrics and Gynecology Sciences and Urologic Sciences, 'Sapienza' University, Rome, Italy.
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: DI Pierro
authors.affiliation: Deptartment of Obstetrics and Gynecology Sciences and Urologic Sciences, 'Sapienza' University, Rome, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Grande
authors.affiliation: Department of Urology, Lucerne Cantonal Hospital, Lucerne, Switzerland.
authors.forename: Livio
authors.initials: L
authors.lastname: Mordasini
authors.affiliation: Department of Urology, Lucerne Cantonal Hospital, Lucerne, Switzerland.
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Danuser
authors.affiliation: Department of Urology, Lucerne Cantonal Hospital, Lucerne, Switzerland a.mattei@gmx.ch.
authors.forename: Agostino
authors.initials: A
authors.lastname: Mattei
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control*; D016522:Oncology Service, Hospital; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000009:adverse effects*; D012371:Robotics; D016896:Treatment Outcome
keywords: Prostate cancer; complications; low-volume centre; oncological and functional outcomes; perioperative results; robot-assisted radical prostatectomy