PURPOSE To analyze urinary continence outcome following robot-assisted radical prostatectomy (RARP) for aggressive prostate cancer in men aged ≥ 70 and < 70 years. METHODS Retrospective analyses of prospectively collected long-term data from a monocentric cohort of 350 men with D'Amico high-risk prostate cancer undergone robot-assisted radical prostatectomy at a single institution between 2005 and 2016. The association between time since operation and zero-pad urinary continence recovery was comparatively analyzed by separate pre-operative and post-operative Cox proportional-hazard regression models. RESULTS Median age in the age group ≥ 70 years was 73 years compared with 62 years in the < 70 year age group. Distribution of men receiving adjuvant and salvage radiotherapy/hormonal therapy was similar in both age groups. Urinary continence recovery rate at 12, 24, and 36 months after surgery of men aged ≥ 70 years was 66, 79 and 83%, respectively, and statistically similar to that of men < 70 years: 71, 81, and 85% (log-rank test p = 0.24). Multivariable analyses demonstrated no significant difference in return to continence between the two age groups (p = 0.28 and p = 0.17). In addition, clinical stage and type of nerve sparing (unilateral, bilateral or non-nerve sparing) were found to be independently predictive of pad-free continence recovery. CONCLUSIONS Regardless of age, return to continence in men with aggressive prostate cancer undergoing RARP continues to improve way beyond the first 12 months after surgery. Considering the dire effects of post-operative radiotherapy on continence in this aggressive cancer cohort, advanced age alone should not discourage recommending multimodal therapy involving RARP.

中文翻译：

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老年男性的无垫尿失禁的恢复与进行侵袭性前列腺癌的机器人辅助根治性前列腺切除术的年轻男性没有区别。

目的分析机器人辅助根治性前列腺切除术（RARP）对≥70岁和<70岁男性的侵袭性前列腺癌的尿尿结局。方法对2005年至2016年间在一家机构中接受机器人辅助根治性前列腺切除术的350名D'Amico高危前列腺癌男性单中心队列的前瞻性收集的长期数据进行回顾性分析。术前和术后分别采用Cox比例风险回归模型对尿垫尿失禁的恢复情况进行了比较分析。结果≥70岁年龄组的中位年龄为73岁，而<70岁年龄组的中位年龄为62岁。在两个年龄组中，接受辅助和挽救性放疗/激素治疗的男性分布相似。≥70岁的男性在术后12、24和36个月的尿失禁恢复率分别为66％，79％和83％，与70岁以下的男性在统计学上相似：71％，81％和85％（log -秩检验p = 0.24）。多变量分析显示两个年龄组之间的大便回报率无显着差异（p = 0.28和p = 0.17）。此外，发现神经保留的临床阶段和类型（单侧，双侧或非神经保留）可独立预测无垫尿失禁的恢复。结论不管年龄多大，在接受RARP的侵袭性前列腺癌男性患者手术后前12个月内，其恢复节制的情况仍在继续改善。考虑到在这个积极的癌症队列中放疗对节制的可怕影响，