Abstract
Introduction
When laparoscopic radical prostatectomy (LRP) was introduced as a novel treatment
option for prostate cancer, it had to compete with the established open techniques.
The short- and intermediate-term oncologic and functional outcomes were encouraging
and comparable to those with retropubic radical prostatectomy. However, the long-term
oncologic safety for LRP has yet to be fully elucidated. We evaluated the long-term
oncologic outcomes of an initial series of patients who had undergone LRP.
Patients and Methods
An initial unselected and consecutive series of 100 patients who had undergone LRP
for clinically localized prostate cancer from 1999 to 2001 was identified. The pre-,
intra-, and postoperative data were collected. Biochemical recurrence (BCR) was defined
as a prostate-specific antigen (PSA) value of ≥ 0.2 ng/mL. The outcome measures were
cancer control (CC), BCR-free survival (BCRFS), cancer-specific survival (CSS), and
overall survival (OS).
Results
The mean patient age was 64 ± 7 years, and the mean preoperative PSA level was 9.6
± 8.3 ng/mL. Of the 100 patients, 79 (79%) had stage pT2 and 15 (15%) had stage pT3
disease. Positive surgical margins were found in 25 patients (25%; 16.4% for pT2 and
40% for pT3). The median follow-up time was 126 months (range, 60-176 months). The
5-year CC rate was 82%. The estimated 10-year BCRFS was 83% and 80% for patients with
stage pT2 and pT3 tumors, respectively. The median time to BCR was 52 months (range,
6-144 months). The estimated 10-year CSS and OS was 98% and 93%, respectively.
Conclusion
Our long-term follow-up data from an initial unselected patient cohort have indicated
that LRP offers excellent long-term oncologic control for patients with localized
prostate cancer.
Keywords
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References
- Laparoscopic radical prostatectomy: initial short-term experience.Urology. 1997; 50: 854-857
- Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies.Eur Urol. 2009; 55: 1037-1063
- Laparoscopic radical prostatectomy: preliminary results.Urology. 2000; 55: 630-634
- Laparoscopic radical prostatectomy: the Montsouris technique.J Urol. 2000; 163: 1643-1649
- Laparoscopic radical prostatectomy: a review.Int Braz J Urol. 2009; 35: 125-137
- Endoscopic extraperitoneal radical prostatectomy: oncological and functional results after 700 procedures.J Urol. 2005; 174: 1271-1275
- Laparoscopic radical prostatectomy: functional and oncological outcomes.Curr Opin Urol. 2004; 14: 75-82
- Laparoscopic radical prostatectomy: oncological evaluation after 1,000 cases a Montsouris Institute.J Urol. 2003; 169: 1261-1266
- Long-term functional and oncological results after retroperitoneal laparoscopic prostatectomy according to a prospective evaluation of 550 patients.World J Urol. 2006; 24: 281-288
- Midterm oncological outcomes of laparoscopic vs open radical prostatectomy (RP).BJU Int. 2013; 112: 190-197
- Long-term oncological and continence outcomes after laparoscopic radical prostatectomy: a single-centre experience.BJU Int. 2012; 110: E985-E990
- Five-year oncological outcomes of endoscopic extraperitoneal radical prostatectomy (EERPE) for prostate cancer: results from a medium-volume UK centre.BJU Int. 2014; 113: 449-457
- Oncologic outcome after extraperitoneal laparoscopic radical prostatectomy: midterm follow-up of 1115 procedures.Eur Urol. 2010; 57: 267-272
- Comparisons of the perioperative, functional, and oncologic outcomes after robot-assisted versus pure extraperitoneal laparoscopic radical prostatectomy.Eur Urol. 2014; 65: 610-619
- Oncologic outcome after laparoscopic radical prostatectomy: 10 years of experience.Eur Urol. 2009; 55: 1014-1019
- Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer.JAMA. 1998; 280: 969-974
- Classification of prostatic carcinomas.Cancer Chemother Rep. 1966; 50: 125-128
- Incidence, etiology, location, prevention and treatment of positive surgical margins after radical prostatectomy for prostate cancer.J Urol. 1998; 160: 299-315
- [EAU guidelines on prostate cancer].Actas Urol Esp. 2009; 33: 113-126
- Cancer progression and survival rates following anatomical radical retropubic prostatectomy in 3,478 consecutive patients: long-term results.J Urol. 2004; 172: 910-914
- Anatomic radical retropubic prostatectomy-long-term recurrence-free survival rates for localized prostate cancer.World J Urol. 2006; 24: 273-280
- Long-term oncological outcomes after laparoscopic radical prostatectomy.BJU Int. 2013; 111: 271-280
- Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy: the 15-year Johns Hopkins experience.Urol Clin North Am. 2001; 28: 555-565
- Positive surgical margin and perioperative complication rates of primary surgical treatments for prostate cancer: a systematic review and meta-analysis comparing retropubic, laparoscopic, and robotic prostatectomy.Eur Urol. 2012; 62: 1-15
- Interobserver variability between expert urologic pathologists for extraprostatic extension and surgical margin status in radical prostatectomy specimens.Am J Surg Pathol. 2008; 32: 1503-1512
- The impact of solitary and multiple positive surgical margins on hard clinical end points in 1712 adjuvant treatment-naive pT2-4 N0 radical prostatectomy patients.Eur Urol. 2013; 64: 19-25
- Impact of biochemical recurrence in prostate cancer among US veterans.Arch Intern Med. 2010; 170: 1390-1395
- TNM Classification of Malignant Tumours.5th ed. Springer Verlag, Berlin1997
Article info
Publication history
Published online: November 17, 2015
Accepted:
November 11,
2015
Received in revised form:
October 22,
2015
Received:
July 27,
2015
Footnotes
H.-H.S. and T.H. contributed equally.
Identification
Copyright
© 2015 Elsevier Inc. All rights reserved.
