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Publication Metadata only Advanced age in non-metastatic prostate cancer: does it matter on the oncological outcomes?(Ankara Hematoloji ve Onkoloji Derneği, 2020) N/A; Canda, Abdullah Erdem; Faculty Member; School of Medicine; 116202Purpose: We evaluated the effect of advanced age on oncological outcomes after radical prostatectomy (RP) in non-metastatic prostate cancer (PCa) patients. Materials and Methods: Totally 593 patients’ data was retrospectively evaluated. All patients were divided into two groups: < 0.001 for the both comparisons). The BRFS rates were 83.9% vs. 80.9%, and 85.2% vs. 39.4% when comparing the younger group to the older group at the 5th , and 10th year of follow-ups, respectively (p = 0.29, and p < 0.001, respectively). Factors of a Gleason score higher than 7 on radical prostatectomy, seminal vesicle invasion, and advanced stage were found to be significant factors affecting BRFS, in univariate analysis. In the multivariate analysis, it denoted advanced pathological stage (T3) and high Gleason score (³8) as prognostic factors affecting BRFS. OS was found to be worse in the older patients’ group and age was found as a primary factor in prediction of OS. Conclusions: There is no relationship between advanced age and oncological outcomes after RP in nonmetastatic PCa patients. / Öz: Amaç: Çalışmamızda radikal prostatektomi (RP) yapılmış, metastatik olmayan prostat kanseri hastalarında ileri yaşın onkolojik sonuçlara etkisini araştırmak amaçlanmıştır. Gereç ve Yöntemler: Toplamda 593 hastanın verileri geriye dönük incelendi. Hastalar 70 yaş altı (n=454) ile 70 yaş ve üzeri (n=139) olarak iki gruba ayrıldı. Demografik, patolojik ve cerrahi sonrası onkolojik sonuçlar iki grup arasında karşılaştırıldı. Birincil hedef nokta olarak ileri yaşın biyokimyasal nüks olmaksızın sağ kalım (BNOS) ve genel sağ kalım (GS) üzerine etkisi değerlendirildi. BNOS ve GS üzerine etki eden faktörlerin değerlendirilmesi için lojistik regresyon analizi yapıldı. 10 yıllık takiplerde BNOS ve GS oranlarını gösteren Kaplan-Meier eğrileri oluşturuldu. Sonuçlar: GS oranları sırasıyla 5 ve 10 yıllık takiplerde daha genç yaştaki hasta grubu ile ileri yaştaki hasta grubu karşılaştırıldığında %85,2’ye karşı %64 ve %67,2’ye karşı %23,7 olarak bulundu (her iki karşılaştırma için de p<0.001 . BNOS oranları sırasıyla 5 ve 10 yıllık takiplerde daha genç yaştaki hasta grubu ile ileri yaştaki hasta grubu karşılaştırıldığında %83,9’a karşı 80.9% ve %85,2’ye karşı %39,4 olarak bulundu (sırasıyla p = 0.29 ve p<0.001). RP sonucundaki Gleason skorunun 7 ve üzerinde olması, seminal vezikül invazyonu ve ileri evre hastalık BNOS üzerine etkin faktörler olarak bulundu. Çok değişkenli analizde ise ileri patolojik evre (pT3) ve yüksek Gleason skoru (8 ve üzeri) BNOS üzerine etkili faktörler olarak bulundu. Genel sağ kalım ileri yaştaki hastaları içeren grupta daha düşük bulundu ve yaş GS üzerine etkin birincil faktör olarak saptandı. Sonuç: Metastaz yapmamış prostat kanseri hastalarında radikal prostatektomi sonrası onkolojik sonuçlar üzerine ileri yaşın bir etkisi görülmemiştir.Publication Metadata only European association of nuclear medicine focus 5: consensus on molecular imaging and theranostics in prostate cancer(Elsevier B.V., 2024) Oprea-Lager, DE; MacLennan, S; Bjartell, A; Briganti, A; Burger, IA; de Jong, I; De Santis, M; Eberlein, U; Emmett, L; Fizazi, K; Gillessen, S; Herrmann, K; Heskamp, S; Iagaru, A; Jereczek-Fossa, BA; Kunikowska, J; Lam, M; Nanni, C; O'Sullivan, JM; Panebianco, V; Sala, E; Sathekge, M; Sosnowski, R; Tombal, B; Treglia, G; Tunariu, N; Walz, J; Yakar, D; Dierckx, R; Sartor, O; Fanti, S.; Tilki, Derya; School of Medicine; Koç University HospitalBackground: In prostate cancer (PCa), questions remain on indications for prostate-specific membrane antigen (PSMA) positron emission tomography (PET) imaging and PSMA radioligand therapy, integration of advanced imaging in nomogram-based decision-making, dosimetry, and development of new theranostic applications. Objective: We aimed to critically review developments in molecular hybrid imaging and systemic radioligand therapy, to reach a multidisciplinary consensus on the current state of the art in PCa. Design, setting, and participants: The results of a systematic literature search informed a two-round Delphi process with a panel of 28 PCa experts in medical or radiation oncology, urology, radiology, medical physics, and nuclear medicine. The results were discussed and ratified in a consensus meeting. Outcome measurements and statistical analysis: Forty-eight statements were scored on a Likert agreement scale and six as ranking options. Agreement statements were analysed using the RAND appropriateness method. Ranking statements were analysed using weighted summed scores. Results and limitations: After two Delphi rounds, there was consensus on 42/48 (87.5%) of the statements. The expert panel recommends PSMA PET to be used for staging the majority of patients with unfavourable intermediate and high risk, and for restaging of suspected recurrent PCa. There was consensus that oligometastatic disease should be defined as up to five metastases, even using advanced imaging modalities. The group agreed that [177Lu]Lu-PSMA should not be administered only after progression to cabazitaxel and that [223Ra]RaCl2 remains a valid therapeutic option in bone-only metastatic castration-resistant PCa. Uncertainty remains on various topics, including the need for concordant findings on both [18F]FDG and PSMA PET prior to [177Lu]Lu-PSMA therapy. Conclusions: There was a high proportion of agreement among a panel of experts on the use of molecular imaging and theranostics in PCa. Although consensus statements cannot replace high-certainty evidence, these can aid in the interpretation and dissemination of best practice from centres of excellence to the wider clinical community. Patient summary: There are situations when dealing with prostate cancer (PCa) where both the doctors who diagnose and track the disease development and response to treatment, and those who give treatments are unsure about what the best course of action is. Examples include what methods they should use to obtain images of the cancer and what to do when the cancer has returned or spread. We reviewed published research studies and provided a summary to a panel of experts in imaging and treating PCa. We also used the research summary to develop a questionnaire whereby we asked the experts to state whether or not they agreed with a list of statements. We used these results to provide guidance to other health care professionals on how best to image men with PCa and what treatments to give, when, and in what order, based on the information the images provide.Publication Metadata only How does posterior rhabdosfinter reconstruction affect the results of robotic radical prostatectomy?(Ankara Hematoloji ve Onkoloji Derneği, 2019) Keske, Murat; Asil, Erem; Gök, Bahri; Hamidi, Nurullah; Atmaca, Ali Fuat; N/A; Canda, Abdullah Erdem; Faculty Member; School of Medicine; 116202INTRODUCTION: There are studies investigating the effect of posterior rhabdosfinkter reconstruction on urinary continent before uretrovesical anastomosis. In this study, we investigated the effect of posterior rhabdosfinkter reconstruction on the results of robotic radical prostatectomy in a high-volume robotic surgery center. METHODS: Procedures were included by 3 surgeons surgeon (AFA,AEC,EA) after having an experience of >50 cases.Group-1: posterior rhabdosfincter reconstruction suture was performed, n=133.Group-2: posterior rhabdosfincter reconstruction suture was not performed, n=439. Mean patient age and preoperative serum PSA were 63.6±6.5 vs 63.1±6.9 years (p=0.505); 10.9±8.7 vs 10.1±8.7 ng/ml in Groups 1 and 2, respectively (p=0.454).Bilateral neurovascular bundle (NVB) sparing, unilateral NVB-sparing and non-NVB sparing were performed in 97 (72.9%), 20 (15%) and 16 (12%) Group-1 and 311 (70.8%), 72 (16.4%) and 56 (12.7%) in Group-2 patients, respectively. RESULTS: Mean prostate weights were 65.7±31.7 gr and 62.2±30.7 gr in Groups 1 and 2, respectively (p=0.259).Mean console time, intraoperative blood loss, duration of hospital stay and urethral catheter removal time in Groups 1 and 2 were 143.8±37.4 vs 143.1±37.6 min (p=0.886); 93.4±68.3 vs 101.2±72.1 cc (p=0.277); 3.8±1.7 vs 4.2±2.1 days (p=0.027) and 8.6±2.9 vs 8.9±3.7 days (p=0.447), respectively.Full continence was defined as no pad usage (0 pad/day). of the available 103 and 322 patients, following removal of the catheter, immediate continence rate was 68.9% and 55.9% in Groups 1 and 2, respectively (p=0.019).On postop 1stmonth, 78.6% and 72.6% of the patients in Groups 1 and 2, respectively were fully continent (p=0.230).On postop 3rd-month, 90.2% and 87.5% of the patients in Groups 1 and 2, respectively were fully continent (p=0.412).On postop 6th-month, 95.1% and 94.4% of the patients in Groups 1 and 2, respectively were fully continent (p=0.612). DISCUSSION and CONCLUSION: We conclude that, due to our experience RARP procedure with posterior rhabdosphincter reconstruction has an advantage in terms of gaining postoperative early urinary continence. / Öz: GİRİŞ ve AMAÇ: Üretrovezikal anastomoz öncesi posterior rhabdosfinkter rekonstrüksiyonu uygulanmasının özellikle kontinans üzerine etkisi konusunda çalışmalar mevcuttur. Bu çalışmada yüksek volümlü robotik cerrahi yapan cerrahlara ait veriler değerlendirilerek posterior rhabdosfinkter rekonstrüksiyonu uygulanmasının robotik radikal prostatektomi (RARP) sonuçları üzerine etkisini araştırdık. YÖNTEM ve GEREÇLER: RARP prosedürleri üç cerrah tarafından gerçekleştirildi (AFA, AEC, EA). Cerrahların gerçekleştirdiği ilk 50 operasyon öğrenme eğrisi nedenli çalışma dışı bırakıldı. Hastalar grup 1 (posterior rhabdosfinkter rekonstrüksiyonu uygulanan) (n=133) ve grup 2 (posterior rhabdosfinkter rekonstrüksiyonu uygulanmayan) (n=439) olarak 2 gruba ayrıldı. Ortalama hasta yaşı sırasıyla grup 1’de 63.6±6.5 grup’2 de 63.1±6.9 (p=0.505) ve serum PSA düzeyi grup 1’de 10.9±8.7 grup 2’de 10.1±8.7 (p=0.454) olarak tespit edildi. Grup 1 ve 2 de sırasıyla 97 (%72.9) ve 311 (70.8%), hastada bilateral nörovasküler demet (NVB) koruma, 20 (%15.0) ve 72 (%16.4) hastada unilateral NVB koruma ile operasyon uygulandı. Sırasıyla grup 1 ve grup 2 de 16 (%12.0) ve 56 (%12.7) hastada NVB korunamadı. BULGULAR: Ortalama prostat ağırlığı 65.7±31.7 gr ve 62.2±30.7 gr olarak bulundu(p=0.259). Ortalama konsol süresi, intraoperatif kan kaybı, hastanede yatış süresi ve üretral kateter çekim süresi grup1 ve grup 2 için sırasıyla 143.8±37.4 vs 143.1±37.6 dakika (p=0.886); 93.4±68.3 vs 101.2±72.1 cc (p=0.277); 3.8±1.7 vs 4.2±2.1 gün (p=0.027) ve 8.6±2.9 vs 8.9±3.7 gün (p=0.447), olarak saptandı. En az 1 yıllık takip süresi olan hastalardan, erken kontinans (sonda çekilmesini takiben kontinan) oranları grup 1(n=103) ve grup 2(n=322) de sırasıyla %68.9 ve %55.9 olarak bulundu(p=0.019). Postoperatif 1. ay total kontinan hasta sayısı grup 1 ve grup 2 de sırasıyla %78.6 and % 72.6 olarak bulundu (p=0.230). Postoperatif 3. ay total kontinan hasta sayısı grup 1 ve grup 2 de sırasıyla %90.2 and %87.5 olarak bulundu (p=0.414). Postoperatif 6. ay total kontinan hasta sayısı grup 1 ve grup 2 de sırasıyla %95.1 and %94.4 olarak bulundu(p=0.612). TARTIŞMA ve SONUÇ: Posterior rhabdosfinkter rekonstrüksiyonu uygulanan hastalarda RARP postoperatif erken kontinans kazanılmasında avantaja sahiptir.Publication Metadata only Optimized hybrid arc for improved sparing of organs at risk: balanced combination of IMRT and VMAT in prostate cancer(Galenos, 2023) Ayhan Bingölbalı; Sağlam, Yücel; School of Medicine; Koç University HospitalObjective: In order to seek a lower toxicity risk prediction in patients with prostate cancer, we have evaluated whether prescribing a potential hybrid radiotherapy of intensity-modulated radiotherapy (IMRT) & volumetric modulated arc therapy (VMAT) optimization might increase sparing of organs at risk (OAR) and target dose conformity. Methods: The cohort for this dosimetric planning study included ten consecutive prostate cancer patients previously treated with double arc VMAT to 78 Gy. New optimized hybrid arc plans for a combination of IMRT (8 step-and-shoot fix fields: 225°, 260°, 295°, 330°, 30°, 65°, 90°, 135°) and VMAT (182°-178° clockwise) besides new IMRT (8 step-and-shoot fix fields: 225°, 260°, 295°, 330°, 30°, 65°, 90°, 135°) plans were generated per patient. Dose volume histogram parameters were compared between treated VMAT, new IMRT and new optimized hybrid arc plans for OAR doses. Results: The optimized hybrid arc technique revealed significantly lower rectum (p=0.005) and bladder (p= 0.005) doses compared to stand alone VMAT and IMRT. Conclusion: The optimized hybrid arc technique appears to combine the advantages of IMRT and VMAT to provide a more conformal and homogeneous plan with better OAR sparing in comparison to standalone VMAT or IMRT plans.Publication Metadata only Prostate-specific antigen nadir and cancer-control outcomes in real-world apalutamide-treated metastatic hormone-sensitive prostate cancer patients: a single-center analysis(ELSEVIER, 2024) Wenzel M, Cano Garcia C, Humke C, Hoeh B, Steuber T.; Merseburger AS, Kluth LA, Chun FKH, Mandel P.; Tilki, Derya; School of Medicine; Koç University HospitalBackground and objective Currently available post hoc phase 3 trial–derived data suggest better cancer-control outcomes in apalutamide-treated metastatic hormone-sensitive prostate cancer (mHSPC) patients achieving an (ultra)low prostate-specific antigen (PSA) nadir. This study aims to validate ultralow PSA nadir cutoffs. Methods Relying on an institutional prostate cancer database, 107 eligible patients were yielded. The currently available PSA nadir cutoffs (SWOG trial: <0.2 ng/ml; ultralow TITAN trial: ≤0.02 vs 0.02–0.2 vs >0.2 ng/ml) and PSA responses (≥99%) were tested for time to castration-resistant prostate cancer (ttCRPC) and overall survival (OS) in mHSPC patients treated with apalutamide. Finally, comparisons were made against abiraterone mHSPC treatment. Key findings and limitations Overall, 107 mHSPC patients treated with apalutamide at a median age of 68 yr and baseline PSA of 29 ng/ml were included. The highest proportion of included patients (40.2%) achieved an ultralow PSA nadir of ≤0.02 ng/ml. Patients reaching the SWOG 9346–defined PSA nadir of <0.2 ng/ml and ultralow PSA nadir of ≤0.02 ng/ml harbored the longest time to metastatic castration-resistant prostate cancer (mCRPC) and OS (all p < 0.05). Moreover, 80% of mHSPC patients treated with apalutamide achieved a PSA response of ≥99%. These patients also harbored better time to mCRPC and OS outcomes, relative to patients with a <99% PSA response (both p < 0.05). In the second step of analyses, a comparison against abiraterone patients showed a significantly higher rate of achieving an ultralow PSA nadir of ≤0.02 ng/ml: 40.2% versus 8.8% for apalutamide versus abiraterone, resulting in a significantly longer ttCRPC for the apalutamide-treated (37 mo) than for the abiraterone-treated (22 mo) group (p = 0.001), even after multivariable adjustment and in sensitivity analyses for high-risk mHSPC patients only. The study is limited by its retrospective design. Conclusions and clinical implications In the real-world setting, most mHSPC patients treated with apalutamide achieve an ultralow PSA nadir, which is associated with better cancer-control outcomes. Moreover, a PSA response of ≥99% predicts better outcomes. In head-to-head comparisons, apalutamide achieves better PSA kinetics and ttCRPC outcomes than abiraterone. Patient summary A prostate-specific antigen (PSA) nadir of <0.02 ng/ml and PSA responses ≥99% are associated with better cancer-control outcomes in metastatic hormone-sensitive prostate cancer patients treated with apalutamide.Publication Metadata only The “ins and outs” of prostate specific membrane antigen (psma) as specific target in prostate cancer therapy(Springer, 2023) Eltit, Felipe; Robinson, Nicole; Yu, Pak Lok Ivan; Pandey, Mitali; Lozada, Jerome; Guo, Yubin; Sharma, Manju; Ozturan, Dogancan; Ganier, Laetitia; Belanger, Eric; Perrin, David M.; Cox, Michael E.; Goldenberg, S. Larry; Lack, Nathan Alan; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of MedicineProstate-specific membrane antigen (PSMA) is expressed in epithelial cells of the prostate gland and is strongly upregulated in prostatic adenocarcinoma, with elevated expression correlating with metastasis, progression, and androgen independence. Because of its specificity, PSMA is a major target of prostate cancer therapy;however, detectable levels of PSMA are also found in other tissues, especially in salivary glands and kidney, generating bystander damage of these tissues. Antibody target therapy has been used with relative success in reducing tumor growth and prostate specific antigen (PSA) levels. However, since antibodies are highly stable in plasma, they have prolonged time in circulation and accumulate in organs with an affinity for antibodies such as bone marrow. For that reason, a second generation of PSMA targeted therapeutic agents has been developed. Small molecules and minibodies have had promising clinical trial results, but concerns about their specificity had arisen with side effects due to accumulation in salivary glands and kidneys. Herein we study the specificity of small molecules and minibodies that are currently being clinically tested. We observed a high affinity of these molecules for PSMA in prostate, kidney and salivary gland, suggesting that their effect is not prostate specific. The search for specific prostate target agents must continue so as to optimally treat patients with prostate cancer, while minimizing deleterious effects in other PSMA expressing tissues. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.Publication Metadata only The 2019 Genitourinary Pathology Society (GUPS) white paper on contemporary grading of prostate cancer(College of American Pathologists, 2021) Epstein, Jonathan I.; Amin, Mahul B.; Fine, Samson W.; Algaba, Ferran; Aron, Manju; Beltran, Antonio Lopez; Brimo, Fadi; Cheville; John C.; Colecchia, Maurizio; Comperat, Eva; Cunha, Isabela Werneck da; Delprado, Warick; DeMarzo, Angelo M.; Giannico, Giovanna A.; Gordetsky, Jennifer B.; Guo, Charles C.; Hansel, Donna E.; Hirsch, Michelle S.; Humphrey, Jiaoti HuangPeter A.; Jimenez, Rafael E.; Khani, Francesca; Kong, Qingnuan; N. Kryvenko, Oleksandr; Kunju, L. Priya; Lal, Priti; Latour, Mathieu; Lotan, Tamara; Maclean, Fiona; Magi-Galluzzi, Cristina; Mehra, Rohit; Menon, Santosh; Miyamoto, Hiroshi; Montironi, Rodolfo; J. Netto, George; Nguyen, Jane K.; O. Osunkoya, Adeboye; Parwani, Anil; Robinson, Brian D.; Rubin, Mark A.; Shah, Rajal B.; So, Jeffrey S.; Takahashi, Hiroyuki; Tavora, Fabio; Tretiakova, Maria S.; True, Lawrence; Wobker, Sara E.; Yang, Ximing J.; Zhou, Ming; Zynger, Debra L.; Trpkov, Kiril; Baydar, Dilek Ertoy; Faculty Member; School of Medicine; 8025Context.—Controversies and uncertainty persist in prostate cancer grading. Objective.—To update grading recommendations. Data Sources.—Critical review of the literature along with pathology and clinician surveys. Conclusions.—Percent Gleason pattern 4 (%GP4) is as follows: (1) report %GP4 in needle biopsy with Grade Groups (GrGp) 2 and 3, and in needle biopsy on other parts (jars) of lower grade in cases with at least 1 part showing Gleason score (GS) 4 þ 4 ¼ 8; and (2) report %GP4: less than 5% or less than 10% and 10% increments thereafter. Tertiary grade patterns are as follows: (1) replace ‘‘tertiary grade pattern’’ in radical prostatectomy (RP) with ‘‘minor tertiary pattern 5 (TP5),’’ and only use in RP with GrGp 2 or 3 with less than 5% Gleason pattern 5; and (2) minor TP5 is noted along with the GS, with the GrGp based on the GS. Global score and magnetic resonance imaging (MRI)targeted biopsies are as follows: (1) when multiple undesignated cores are taken from a single MRI-targeted lesion, an overall grade for that lesion is given as if all the involved cores were one long core; and (2) if providing a global score, when different scores are found in the standard and the MRI-targeted biopsy, give a single global score (factoring both the systematic standard and the MRI-targeted positive cores). Grade Groups are as follows: (1) Grade Groups (GrGp) is the terminology adopted by major world organizations; and (2) retain GS 3 þ 5 ¼ 8 in GrGp 4. Cribriform carcinoma is as follows: (1) report the presence or absence of cribriform glands in biopsy and RP with Gleason pattern 4 carcinoma. Intraductal carcinoma (IDC-P) is as follows: (1) report IDC-P in biopsy and RP; (2) use criteria based on dense cribriform glands (.50% of the gland is composed of epithelium relative to luminal spaces) and/or solid nests and/or marked pleomorphism/necrosis; (3) it is not necessary to perform basal cell immunostains on biopsy and RP to identify IDC-P if the results would not change the overall (highest) GS/GrGp part per case; (4) do not include IDC-P in determining the final GS/GrGp on biopsy and/or RP; and (5) ‘‘atypical intraductal proliferation (AIP)’’ is preferred for an intraductal proliferation of prostatic secretory cells which shows a greater degree of architectural complexity and/or cytological atypia than typical high-grade prostatic intraepithelial neoplasia, yet falling short of the strict diagnostic threshold for IDC-P. Molecular testing is as follows: (1) Ki67 is not ready for routine clinical use; (2) additional studies of active surveillance cohorts are needed to establish the utility of PTEN in this setting; and (3) dedicated studies of RNA-based assays in active surveillance populations are needed to substantiate the utility of these expensive tests in this setting. Artificial intelligence and novel grading schema are as follows: (1) incorporating reactive stromal grade, percent GP4, minor tertiary GP5, and cribriform/intraductal carcinoma are not ready for adoption in current practice. © 2021 College of American Pathologists. All rights reserved.Publication Restricted The role of KDM3B in castration resistant prostate cancer(Koç University, 2018) Saraç, Hilal; Lack, Nathan Alan; 0000-0001-7399-5844; Koç University Graduate School of Sciences and Engineering; Molecular Biology and Genetics; 120842Publication Metadata only We investigated the impact of transurethral resection of the prostate (TUR-P) on perioperative outcomes in patients who underwent robot assisted radical prostatectomy (RARP)(Avrasya Üroonkoloji Derneği, 2019) Keske, Murat; Atmaca, Ali Fuat; Hamidi, Nurullah; N/A; N/A; Canda, Abdullah Erdem; Balbay, Mevlana Derya; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 116202; 153320We investigated the impact of transurethral resection of the prostate (TUR-P) on perioperative outcomes in patients who underwent robot assisted radical prostatectomy (RARP). Material and Methods: A total of 752 cases performed by 3 surgeons between February 2009 and December 2017 were reviewed retrospectively. First 100 cases of each surgeon were not included to exclude the learning curve effect. All patients (n = 452) were divided into two groups according to having a previous TUR-P history as Group 1 = patients with TUR-P history (n = 38), Group 2 = patients without TUR-P history (n = 414). Results: Mean patient age was 68.3± 5.9 versus 63.3±6.8 years p=0.00; mean console time was 144.3±37.1 versus 124.6±24.0 minutes, p=0.02; bladder neck reconstruction was 31.6% versus 16.7%, p=0.02; transurethral catheter removal time was 11.3±5.1 versus 8.6±2.7 days, p=0.00; for groups 1 and 2, respectively. Positive surgical margin rates were 26.3% versus 27.3%, p=0.897; erectile function (IIEF≥17) rates on postoperative 12th-month were 60% versus 67%, p=0.644 for groups 1 and 2, respectively. First 3 months continence rates were 52.6% versus 72%, p=0.035 for groups 1 and group 2, respectively. Postoperative 12. month continence rates were similar for group 1 and 2(94.7% vs 97.3% ; p=0.562). Conclusion: RARP after TUR-P has similar oncological outcomes, longer operative time, worse postoperative early continence acquisition rates and longer urethral catheter removal time. / Öz: Bu çalışmada robot yardımlı radikal prostatektomi (RYRP) yapılan hastalarda geçirilmiş transüretral prostat rezeksiyonu (TUR-P) cerrahisinin perioperatif sonuçlar üzerine etkisi araştırılmıştır. Gereç ve Yöntemler: Şubat 2009-Aralık 2017 arasında 3 cerrah tarafından gerçekleştirilen toplam 752 vakanın verileri retrospektif olarak incelendi. Her bir cerrahın ilk 100 vakası öğrenme eğrisi nedeniyle çalışma dışı bırakıldı. Tüm hastalar (n=452) RYRP öncesinde TUR-P öyküsü olup olmamasına göre iki gruba ayrıldı. Grup 1=TUR-P öyküsü olanlar (n=38), Grup 2=TUR-P öyküsü olmayanlar, (n=414). Bulgular: Sırasıyla grup 1 ve 2’de ortalama hasta yaşı 68.3± 5.9 ve 63.3±6.8 yıl p=0.00; ortalama konsol süresi 144.3±37.1 ve 124.6±24.0 dakika, p=0.02; mesane boynu rekonstrüksiyon gereksinim oranı %31.6 ve %16.7, p=0.02; ortalama transüretral kateter kalış süresi 11.3±5.1 ve 8.6±2.7 gün, p=0.00 saptanmıştır. Sırasıyla grup 1 ve 2’de, pozitif cerrahi sınır, grup 1’de %26.3, grup 2’de %27.3, p=0.897 ve erektil fonksiyon oranları (IIEF≥17) (postoperatif 12. ay grup 1’de %60, grup 2’de %67, p=0.644) benzer saptanmıştır. Erken dönemde (3. ay) kontinans oranları grup 1 ve grup 2 de sırasıyla %52.6 ve %72 olarak bulunmuştur (p=0.035). 12. ay sonunda kontinans oranları açısından iki grupta %94.7 ve %97.3 olarak birbirine benzer sonuçlar elde edilmiştir (p=0.562). Sonuç: TUR-P sonrası RYRP ameliyatı yapılması, TUR-P geçirmeyen hastalara göre benzer onkolojik sonuçları olan, daha uzun ameliyat süresi olan, postoperatif erken kontinans kazanılması oranları daha az olan ve daha uzun süre idrar sondası takılması gerektiren bir ameliyattır.