ObjectiveTo compare the peri‐operative outcomes of radical prostatectomy (RP) for locally advanced, node‐positive, and metastatic prostate cancer (PCa), as determined through pathological staging, using the American College of Surgeons National Surgical Quality Improvement Project.MethodsWe identified RP procedures performed between 2019 and 2021. Patients were stratified by pathological staging to compare the effect of locally advanced disease (T3‐4), node positivity (N+) and metastasis (M+) vs localised PCa (T1‐2 N0 M0). Baseline demographics and 30‐day outcomes, including operating time, length of hospital stay (LOS), 30‐day mortality, readmissions, reoperations, major complications, minor complications and surgery‐specific complications, were compared between groups.ResultsPathological staging data were available for 9276 RPs. Baseline demographics were comparable. There was a slightly higher rate of minor complications in the locally advanced cohort, but no significant difference in major complications, 30‐day mortality, readmissions, or rectal injuries. Node positivity was associated with longer operating time, LOS, and some slightly increased rates of 30‐day complications. RP in patients with metastatic disease appeared to be similarly safe to RP in patients with M0 disease, although it was associated with a longer LOS and slightly increased rates of certain complications.ConclusionsFor patients with pathologically determined locally advanced, node‐positive, and metastatic PCa, RP appears to be safe, and is not associated with significantly higher rates of 30‐day mortality or major complications compared to RP for localised PCa. This study adds to the growing body of literature investigating the role of RP for advanced PCa; further studies are needed to better characterise the risks and benefits of surgery in such patients.

中文翻译：

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晚期前列腺癌根治性前列腺切除术的围手术期结果

目的根据美国外科医生学会国家手术质量改进项目的病理分期确定，比较根治性前列腺切除术 (RP) 治疗局部晚期、淋巴结阳性和转移性前列腺癌 (PCa) 的围手术期结果。 2019 年至 2021 年间进行的手术。按病理分期对患者进行分层，以比较局部晚期疾病 (T3-4)、淋巴结阳性 (N+) 和转移 (M+) 与局部 PCa (T1-2 N0 M0) 的效果。比较各组之间的基线人口统计学和 30 天结果，包括手术时间、住院时间 (LOS)、30 天死亡率、再入院、再次手术、主要并发症、轻微并发症和手术特异性并发症。结果提供病理分期数据9276 RP。基线人口统计数据具有可比性。局部晚期队列中轻微并发症的发生率略高，但主要并发症、30 天死亡率、再入院或直肠损伤方面没有显着差异。淋巴结阳性与较长的手术时间、LOS 以及 30 天并发症发生率略有增加相关。转移性疾病患者中的 RP 似乎与 M0 疾病患者中的 RP 具有相似的安全性，尽管 RP 与更长的 LOS 和某些并发症发生率略有增加有关。结论对于病理确定的局部晚期、淋巴结阳性和转移性 PCa 患者与 RP 治疗局部 PCa 相比，RP 似乎是安全的，并且与显着较高的 30 天死亡率或主要并发症无关。这项研究为越来越多的研究 RP 在晚期 PCa 中的作用的文献提供了补充。需要进一步的研究来更好地描述此类患者手术的风险和益处。