Oncologic Outcome After Laparoscopic Radical Prostatectomy: 10 Years Of Experience

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Cancer / Oncology
Article Date: 26 Dec 2008 - 0:00 PDT

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UroToday.com - Long-term oncologic outcomes for laparoscopic radical prostatectomy (LRP) are lacking. In the online edition of European Urology, Dr. Karim Touijer and associates from Dr. Bertrand Guillonneau's group published their 10-year oncologic results following LRP.

Between 1998 and 2007, 1,564 consecutive patients underwent LRP; first at Montsouris Institute in Paris, then subsequently at Memorial Sloan-Kettering Cancer Center in New York. Most cases were performed after 2003. Surgical technique was the Montsouris technique with modifications after 2003. Intermediate and high-risk cases represented 52% and 12% of the total case population, respectively.

The overall positive surgical margin rate was 12%. Two patients died from prostate cancer (CaP) and 20 died from other causes. In follow-up, there was one local recurrence, 10 metastatic recurrences, and 153 biochemical recurrences. The actuarial probability of remaining free of progression at 5 and 8 years postoperatively was 78% and 71%. The 5-year progression-free probability for patients classified as low-, intermediate- and high-risk was 91%, 77%, and 53%. By pathologic stage, 5-year freedom from CaP progression after LRP was 83% for pT2 and 69% for pT3, node-negative cancers. Among 366 men who had a >1% chance of lymph node metastasis and underwent a lymph node dissection (after 2005), 38 (10%) were found to have lymph node metastasis. The median number of lymph nodes excised in this group was 13.

Touijer K, Secin FP, Cronin AM, Katz D, Bianco F, Vora K, Reuter V, Vickers AJ, Guillonneau B
Eur Urol. 2008 Nov 6. (Epub ahead of print)
doi:10.1016/j.eururo.2008.10.036

Written by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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