# Pelvic fascia spARing radical prostatectomy TrIAL (PARTIAL)

> **NIH NIH R01** · WEILL MEDICAL COLL OF CORNELL UNIV · 2022 · $733,721

## Abstract

PROJECT SUMMARY/ABSTRACT
 Radical prostatectomy (RP) is a standard treatment for localized prostate cancer with 60,000 procedures
per year in the U.S. Commonly recognized long-term adverse events of RP include persistent urinary
incontinence (~20%) and erectile dysfunction (~65%). Less commonly known risks include penile shortening
(~50%), penile deformity/curvature (~15%), and inguinal hernia (~15%). These adverse events lower health-
related quality of life, cause decision regret and require additional treatment. A new surgical technique, pelvic
fascia-sparing RP (PFS-RP), preserves fascial support structures, arterial supply to the penis, and nerves that
are severed and resected during conventional RP. Several retrospective series have shown significaly reduced
urinary and erectile dysfunction after PFS-RP. However, these studies have been small and had limited follow-
up for oncologic endpoints. A multi-center, randomized controlled trial (RCT) with longer follow-up is clearly
indicated. However, adequately powered surgical RCTs face significant challenges: 1) a traditional RCT of this
new technique would cost ~$10 million; and 2) typically, such RCTs accrue only about six patients per center
per year and often close prematurely due to low accrual. Indeed, there is almost a complete absence of
sufficiently powered RCTs in oncologic surgery. After considering these challenges, we developed two innovative
methodological approaches that have strong published, preliminary data. The first is to use a two-stage RCT
consent that lowers information overload, decisional burden, and anxiety. Making consent easier for patients
also reduces the burden on surgeon investigators making them more willing to accrue. Preliminary data suggest
that two-stage consent dramatically improves accrual – in one recent study, 98% of eligible patients were accrued
- while maintaining patient understanding of consent as assessed by a standard questionnaire. The second
innovation employs a web-based portal to incentivize self-entry of patient-reported outcomes by giving patients
feedback and advice in response to their answers. This portal has already been used by ~15,000 patients and
captured the endpoint for two RCTs. We propose a RCT using these two novel methodologic approaches. This
will randomized 600 patients to PFS-RP or traditional RP conducted at four centers that receive NCI SPORE
awards for prostate cancer. We will test whether PFS-RP is able to reduce urinary and erectile function, as well
as immediate surgical complications, while being non-inferior for cancer control. The study will include a rigorous
surgeon quality assurance approach, involving surgical videos uploaded to a central site and quantitative scoring
of discrete surgical steps. Successful completion of the study would not only provide evidence on the best
practice for one of the most common cancer operations but provide a novel methodological approach that could
facilitate future studies in surg...

## Key facts

- **NIH application ID:** 10366347
- **Project number:** 1R01CA259173-01A1
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Mohamad Allaf
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $733,721
- **Award type:** 1
- **Project period:** 2022-02-04 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10366347

## Citation

> US National Institutes of Health, RePORTER application 10366347, Pelvic fascia spARing radical prostatectomy TrIAL (PARTIAL) (1R01CA259173-01A1). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10366347. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*
