INTRODUCTION: Robot-assisted laparoscopic radical prostatectomy is now considered the gold standardtreatment of prostate adenocarcinoma in the modern world. There are two approaches to the precisedissection of seminal vesicles (anterior and posterior) during a laparoscopic radical prostatectomy,each of which with unique advantages and disadvantages. Primarily, the authors compared theintraoperative and oncological outcomes of these two approaches. Secondary objective included theestablishment of the minimum number of cases before a surgeon can enter the competent phase of thelearning curve. MATERIALS AND METHODS: Chart review was performed on 111 patients who underwent RALP from2014-2016 performed by 3 experienced robotic surgeons with interchangeability of role as consoleoperator. Two arms were developed based on the approach of seminal vesicle dissection, that is,anterior and posterior approach. Cumulative summation of the console time was performed to obtaina chart with a) negative slope-learning phase and b) positive slope-competent phase. Patients underthe competent phases were included for analysis. RESULTS: There were no significant differences in age, body mass index, prostate volume, preoperativeprostate specific antigen (PSA), gleason score and oncologic risk. Pathology was almost similar inmajority of cases under the anterior approach arm being gleason 7 (3+4) and posterior approach armbeing gleason 6 (3+3). With a p-value of <0.05, console time was significantly shorter in the posteriorapproach at 121±25.95 when compared to anterior approach at 148±30.25 minutes. The otherperioperative and postoperative outcomes were not significantly different between the groups. CONCLUSION Posterior approach has provided a shorter console time, while the overall oncologic andperioperative outcomes for both approaches were similar. The learning curve for the anterior approachis less steep than that of the posterior approach with only 14 versus 26 consecutive cases, respectively,to be able to competently perform RALP.

OBJECTIVE: Prostate cancer is the most common cancer in men and localized prostate adenocarcinoma has multiple treatment options. In this study, the objective was to review the outcome of patients that were treated with HDR brachytherapy as monotherapy in all prostate adenocarcinoma patients at the St Luke's Medical Center.

MATERIALS AND METHODS: Thirty three (33) patients who underwent HDR prostate brachytherapy as monotherapy for prostate adenocarcinoma in a single institution for the past 5 years received 38 Gy in 4 fractions. The charts of these patients were reviewed to determine biochemical control using the Phoenix criteria and ASTRO definition, and toxicity.

RESULTS: Patients showed good biochemical control, with 92.16% meeting the target PSA value of 2 ng/mL or less and a 96.51% without consecutive rise of PSA post brachytherapy. There was also minimal toxicity, with no report of gastrointestinal toxicity and 9.1% rate of temporary genitourinary toxicity.

CONCLUSION: Good biochemical control of prostate adenocarcinoma was achieved with the use of HDR brachytherapy as monotherapy, with a minimal toxicity profile.

Human ; Male ; Aged ; Middle Aged ; Brachytherapy ; Adenocarcinoma ; Prostate