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was diagnosed based on mpMRI and targeted biopsies and
who had RP. The risk of PMs is higher for TZ- than for PZ-
originated cancers, whereas there are no differences in
biochemical recurrence (BCR)–free or overall survival
. Our 35% post/lateral rate of PMs (6 of 17 cases) led
to recurrence in 4 of 6 cases. A frozen section margin
assessment on the predominant side of the tumor might
have led to a more extended excision of the PZ horn or to
immediate RP. Fifth, completion RP was performed for four
patients who recurred, was judged feasible with the
possibility of the nerve-sparing technique, and excellent
oncologic and outcomes were observed with a mean follow-
up of 5 yr for three of four cases. Functional outcomes were
similar to what is observed after RP as the primary
treatment.
Limitations of the study include the small sample size
associated with quite wide CIs for reported outcomes. It also
includes the absence of an alternative biopsy scheme or
approach such as template transperineal mapping for case
selection.
5. Conclusions
Robotic partial prostatectomy for isolated anterior cancer is
feasible, with good functional results and 86% BCR-free
survival at 24 mo of follow-up. Partial prostatectomy is an
option for highly selected men with anterior cancers as an
alternative to other focal ablative therapy. CIs are quite
wide for reported outcomes, suggesting that while promis-
ing, much more research is needed to verify our initial
outcomes, adding QOL questionnaires to assess overall
benefits or harms of this technique before being recom-
mended or not advised as a reasonable alternative to
standard therapies.
Author contributions: Arnaud Villers had full access to all the data in the
study and takes responsibility for the integrity of the data and the
accuracy of the data analysis.
Study concept and design: Villers, Gill, Puech.
Acquisition of data: Villers, Puech, Lemaitre, Leroy, Gill, Desai, Haber,
Flamand.
Analysis and interpretation of data: Villers, Puech, Gill, Crouzet, Chopra.
Drafting of the manuscript: Villers, Gill.
Critical revision of the manuscript for important intellectual content: Villers,
Puech, Gill.
Statistical analysis: Ouzzane.
Obtaining funding: None.
Administrative, technical, or material support: None.
Supervision: None.
Other (specify): None.
Financial disclosures: Arnaud Villers certifies that all conflicts of interest,
including specific financial interests and relationships and affiliations
relevant to the subject matter or materials discussed in the manuscript
(eg, employment/ affiliation, grants or funding, consultancies, honoraria,
stock ownership or options, expert testimony, royalties, or patents filed,
received, or pending), are the following: None.
Funding/Support and role of the sponsor: None.
Acknowledgments: We thank Laura Lecuyer for data collection and table
construction and Gauthier Marcq for statistical help.
Appendix A. Supplementary data
Supplementary data associated with this article can be
found, in the online version, at
.
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