Abstract
As life expectancy increases, a growing number of older adults undergo radical prostatectomy for localized prostate cancer; however, longitudinal age-specific functional outcomes remain insufficiently characterized. We conducted a prospective multicenter cohort study evaluating age-stratified trajectories of patient-reported outcomes (PROs) assessed using the Expanded Prostate Cancer Index Composite (EPIC) and perioperative complications following robot-assisted radical prostatectomy (RARP). A total of 604 patients were categorized into three age groups (< 65, 65–74, and ≥ 75 years). PROs were assessed using the EPIC at baseline and at 1, 3, 6, and 12 months postoperatively, and longitudinal changes were analyzed using linear mixed-effects models. Urinary function declined transiently after surgery in all age groups and substantially recovered by 12 months, with no significant differences between men aged ≥ 75 years and younger patients. Sexual function decreased irrespective of age, although younger patients maintained higher absolute scores after nerve-sparing procedures. In contrast, sexual bother demonstrated an age-dependent pattern, with minimal change observed in men aged ≥ 75 years. Perioperative complication rates did not differ significantly across age groups. These findings suggest that chronological age alone should not preclude consideration of RARP in appropriately selected elderly patients and provide evidence supporting individualized surgical decision-making in an aging population.
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The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
We would like to thank all the patients, their family members, and the staff of all participating departments.
Funding
This project was financially supported by Osaka foundation for the prevention of cancer and cardiovascular diseases (project code S19YK015).
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Norihiko Kawamura: Conceptualization; data curation; writing—original draft; project administration; visualization. Masashi Nakayama: Visualization; writing—review and editing. Yusuke Inagaki: Data curation; writing—eview and editing. Koichi Tsutahara: Data curation; writing—review and editing. Koji Hatano: Data curation; writing—review and editing.Jiro Nakayama: Data curation; writing—review and editing. Yohei Okuda: Data curation; writing—review and editing. Yosuke Sekii: Data curation; writing—review and editing. Koji Yazawa: Data curation; writing—review and editing. Tetsuya Takao: Data curation; writing—review and editing. Norio Nonomura: Data curation; writing—review and editing. Masao Tsujihata: Data curation; writing—review and editing. Yasushi Miyagawa: Data curation; writing—review and editing. Hitoshi Takayama: Data curation; writing—review and editing. Akira Nagahara: Data curation; writing—review and editing. Kazuo Nishimura: Supervision.
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The current study adhered to the ethical principles outlined in the Declaration of Helsinki and received approval from the Ethics Review Board of the Osaka International Cancer Institute (Approval Number: 19176-4). Written informed consent was obtained from all participants prior to inclusion in the study.
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Kawamura, N., Nakayama, M., Inagaki, Y. et al. Age-stratified trajectories of patient-reported outcomes and perioperative safety after robot-assisted radical prostatectomy: a prospective multicenter cohort study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-46171-z
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DOI: https://doi.org/10.1038/s41598-026-46171-z
