Long-term oncological outcomes after laparoscopic radical prostatectomy

• Verfasst von: Fiedler, Marcel [VerfasserIn]
• Verfasst von: Lorenzo Bermejo, Justo [VerfasserIn]
• Verfasst von: Flinspach, Bettina [VerfasserIn]
• Verfasst von: Schulze, Michael [VerfasserIn]
• Verfasst von: Teber, Dogu [VerfasserIn]
• Verfasst von: Rumpelt, Hans Joachim [VerfasserIn]
• Verfasst von: Rassweiler, Jens Jochen [VerfasserIn]
• Titel: Long-term oncological outcomes after laparoscopic radical prostatectomy
• Verf.angabe: Marcel Hruza, Justo Lorenzo Bermejo, Bettina Flinspach, Michael Schulze, Dogu Teber, Hans Joachim Rumpelt and Jens Jochen Rassweiler
• Jahr: 2013
• Umfang: 10 S.
• Fussnoten: Gesehen am 29.10.2021
• Titel Quelle: Enthalten in: BJU international
• Ort Quelle: Oxford : Wiley-Blackwell, 1999
• Jahr Quelle: 2013
• Band/Heft Quelle: 111(2013), 2, Seite 271-280
• ISSN Quelle: 1464-410X
• DOI: doi:10.1111/j.1464-410X.2012.11317.x
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: laparoscopy
• Sach-SW: oncological outcomes
• Sach-SW: prostate cancer
• Sach-SW: prostatectomy
• K10plus-PPN: 1775760995

Abstract

What's known on the subject? and What does the study add? Laparoscopic radical prostatectomy (LRP) has shown good oncological short-term and mid-term outcomes, but long-term outcomes are still lacking. We present long-term oncological outcomes of LRP in a large cohort of patients operated on in one of the pioneering European centres. The data from the present study show high rates of biochemical and clinical recurrence-free survival and low cancer-specific mortality compared with open series. 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.