Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) allows the preservation of the structures advocated to play a crucial role in the continence mechanism. This study aims to evaluate the association between adjuvant radiation therapy (aRT) and urinary continence (UC) recovery after RS-RARP. For the purpose of the current study, all patients submitted to RS-RARP for prostate cancer (PCa) at a single high-volume European institution between January 2010 and December 2021 were identified. Only patients that harbored pT2 stage with positive surgical margins or pT3/pN1 stage with or without positive surgical margins were included in the analyses. Two groups of patients were identified as follows: patients who had undergone aRT and patients submitted to observation (no-aRT patients). As per definition, aRT was delivered within 1–6 months after surgery. After 1:1 propensity score matching, 124 aRT patients were compared with 124 no-aRT patients who continued standard follow-up protocol after surgery. UC recovery was 81 vs. 84% in aRT vs. no-aRT patients (p= 0.7). In multivariable Cox regression analyses, aRT did not reach the independent predictor status for UC recovery at 12 months. In the subgroup analysis including only aRT patients, only the nerve-sparing technique was independently associated with UC recovery at 12 months. Conversely, the type of aRT (IMRT/VMAT vs. 3D-CRT) did not reach the independent predictor status for UC recovery at 12 months. The current study is the first to address the association between aRT and UC recovery in patients treated with RS-RARP for PCa. Based on our data, aRT is not associated with worse UC recovery. In the cohort of patients treated with aRT, the nerve-sparing technique independently predicted UC recovery.
保留Retzius间隙的机器人辅助根治性前列腺切除术（RS-RARP）能够保护在控尿机制中发挥关键作用的结构。本研究旨在评估RS-RARP术后辅助放射治疗（aRT）与尿控功能恢复之间的关联。本研究纳入了2010年1月至2021年12月期间在欧洲一家大型医疗中心接受RS-RARP治疗前列腺癌的所有患者。分析仅包括病理分期为pT2期伴手术切缘阳性，或pT3/pN1期伴或不伴手术切缘阳性的患者。患者被分为两组：接受aRT的患者和接受观察（未接受aRT）的患者。根据定义，aRT在术后1-6个月内进行。经过1:1倾向评分匹配后，将124例aRT患者与124例术后仅接受标准随访的未行aRT患者进行比较。aRT组与未行aRT组的尿控恢复率分别为81%和84%（p=0.7）。在多变量Cox回归分析中，aRT并未成为12个月时尿控恢复的独立预测因素。在仅包含aRT患者的亚组分析中，只有保留神经技术是12个月时尿控恢复的独立相关因素。相反，aRT的类型（调强放疗/容积旋转调强放疗 vs. 三维适形放疗）并未成为12个月时尿控恢复的独立预测因素。本研究首次探讨了接受RS-RARP治疗的前列腺癌患者中aRT与尿控恢复之间的关联。根据我们的数据，aRT与更差的尿控恢复无关。在接受aRT治疗的患者队列中，保留神经技术独立预测了尿控恢复。
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