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Long-term oncological outcomes after laparoscopic radical prostatectomy.

Abstract：

OBJECTIVES:To investigate long-term oncological outcomes after laparoscopic radical prostatectomy (LRP). To identify parameters influencing recurrence-free survival in a single-institution series. PATIENTS AND METHODS:All patients underwent LRP using the transperitoneal retrograde Heilbronn technique. High-risk patients received adjuvant treatment according to an institutional algorithm based on prostate-specific antigen (PSA), Gleason score, tumour-node-metastasis stage, margin status and tumour volume. Data were collected prospectively on operative and postoperative parameters beginning in 1999. Complete follow-up data of 370 of the first 500 consecutive patients are available. Biochemical recurrence was defined as two consecutive PSA levels <0.2 ng/mL within the follow-up period. Kaplan-Meier estimates and Cox regression were applied to examine recurrence-free survival times. RESULTS:The estimated biochemical recurrence-free survival (BCRFS) rates 10 years after LRP were 80.2% in patients staged pT2, 47.4% in those staged pT3a and 49.8% in those staged pT3b/4, confirming a better prognosis in patients with organ-confined disease (P < 0.001). In the multivariate Cox regression analysis, only Gleason score and pT stage significantly influenced BCRFS. The 10-year clinical progression-free survival rates were 97.2% (pT2), 84.4% (pT3a) and 78.1% (pT3b/4), and prostate cancer-specific survival estimates were 100% (pT2), 97.3% (pT3a) and 90.6% (pT3b/4). CONCLUSIONS:The 10-year biochemical and clinical progression-free survival after LRP combined with a risk-adapted concept of adjuvant therapy is high, while prostate-cancer specific mortality is low. Our data shows no negative impact of laparoscopic techniques on oncologic outcomes compared to large series after retropubic radical prostatectomy. In a multivariate Cox regression, only Gleason score and pT stage had significant impact on BCRFS.

journal_name

BJU Int

journal_title

BJU international

authors

Hruza M,Bermejo JL,Flinspach B,Schulze M,Teber D,Rumpelt HJ,Rassweiler JJ

doi

10.1111/j.1464-410X.2012.11317.x

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

271-80

issue

eissn

1464-4096

issn

1464-410X

journal_volume

111

pub_type

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Long-term oncological outcomes after laparoscopic radical prostatectomy.