OBJECTIVE: To investigate oncological safety and effectivity of laparoscopic radical prostatectomy (LRP) on clinically T3 (cT3) prostate cancer (PCa) in comparison to T1 and T2 stages.
MATERIALS AND METHODS: All consecutive 2375 LRPs were evaluated between 1999 and 2013. Of the 1751 patients enrolled with complete follow-up data (>24 months). Patients were divided into 3 groups according to clinical stage of PCa by using TNM classification. Group 1 consisted of patients with clinically T1 (cT1), group 2 consisted of patients with cT2, and group 3 consisted of patients with cT3 PCa. Demographic, postoperative, and long term data of patients were recorded and statistical analyses were performed.
RESULTS: Mean age was 63.6±6.2 years. Mean follow-up was 104±28.4 months. There were 417 patients in group 1, 842 patients in group 2, and 492 patients in group 3. Mean prostate specific antigen level, Gleason score in prostate biopsies, rate of tumour volume, body mass index, age, were higher in group 3 (p< 0.001). Nerve sparing techniques were more performed in group 1 than other groups (p< 0.001). The mean extracapsular extension, seminal vesicle invasion, Gleason score, positive surgical margin (PSM), rate of adjuvant hormone and radiotherapies were higher in group 3 than other groups. However, urinary continence was similar in all groups. Group 1 had more ability for penetration. Group 1 had higher cancer specific survival rate than other groups, whereas, overall survival rates and complications were similar in all groups.
CONCLUSION: LRP seems effective and safe for clinical T3 PCa with similar overall survival rates with cT1 and cT2. Additional therapies may support these rates. LRP can be part of treatment of patients with cT3 Pca.
Written by:
Gözen AS, Akin Y, Ates M, Hruza M, Rassweiler J. Are you the author?
Department of Urology, SLK-Klinikum Heilbronn, University of Heidelberg, 74078, Heilbronn, Germany.
Reference: BJU Int. 2014 Feb 27. Epub ahead of print.
doi: 10.1111/bju.12710
PubMed Abstract
PMID: 24571244
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