First Retrospective Analysis of Robot-Assisted Radical Prostatectomy Results in Uruguay

Background In Uruguay, prostate cancer is currently the most frequently diagnosed cancer in males and the second leading cause of cancer death. However, the mortality rate has been decreasing due to early diagnosis and treatment. Robotic surgery has played a very important role in the surgical treatment of prostate cancer, becoming the gold standard approach in different countries of the world. Only one robotic platform has been available in Uruguay since 2011. This study aimed to evaluate the perioperative, oncologic, and functional outcomes of the initial experience with robot-assisted radical prostatectomy in Uruguay, and to contextualize these results within internationally reported outcomes. Methodology This retrospective study analyzed outcomes of 70 patients who underwent radical robotic prostatectomy performed by a single surgeon during the initial phase of his robotic learning curve, defined as the first 70 consecutive cases performed under direct supervision by a certified proctor between March 2015 and December 2022. Results We report perioperative data, pathological findings, functional and oncological outcomes, and complications. The pathology report showed a 22.85% positive margin rate (11.11% of pT2 and 44% of pT3). The mean follow-up was 38 months. Complete continence was achieved in 93.54% of cases and potency in 66.12%. The conversion rate to open surgery was 1.42%, and Clavien grade III complications occurred in 4.2% of cases. Biochemical recurrence was observed in 19.35% of patients. Patients with positive margins and pT3 disease had significantly higher biochemical recurrence rates, and Kaplan-Meier analysis demonstrated a restricted mean biochemical recurrence-free survival of 50.7 months (95% confidence interval = 45.9-55.5). Conclusions Our functional and oncological outcomes and complication rates appear to be within the range reported in the international literature.