Oncologic outcome after laparoscopic radical prostatectomy: 10 years of experience Journal Article

Authors: Touijer, K.; Secin, F. P.; Cronin, A. M.; Katz, D.; Bianco, F.; Vora, K.; Reuter, V.; Vickers, A. J.; Guillonneau, B.
Article Title: Oncologic outcome after laparoscopic radical prostatectomy: 10 years of experience
Abstract: Background: While the published short-term oncologic outcomes after laparoscopic radical prostatectomy (LRP) are encouraging, intermediate and long-term data are lacking. Objective: We analyzed the oncologic outcome after LRP based on 10 yr of experience. Design, setting, and participants: This retrospective analysis of data prospectively collected from 1998 to 2007 studies 1564 consecutive patients with clinically localized prostate cancer (cT1c-cT3a) who underwent LRP. Intervention: LRP was performed by two surgeons at either L'Institut Mutualiste Montsouris (IMM) in Paris, France, or Memorial Sloan-Kettering Cancer Center (MSKCC) in New York City, USA. Measurements: Progression of disease was defined as a prostate-specific antigen (PSA) of ≥0.1 ng/ml with confirmatory rise or initiation of secondary therapy. Patients were stratified as low, intermediate, or high risk based on the pretreatment prostate cancer nomogram progression-free probability of >90%, 89-71%, and <70%, respectively. Results and limitations: The overall 5-yr and 8-yr probability of freedom from progression (PFP) was 78% (95% confidence interval [CI], 74-82%) and 71% (95% CI, 63-78%), respectively. For low-, intermediate-, and high-risk cancer, the 5-yr PFP was 91% (95% CI, 85-95%), 77% (95% CI, 71-82%), and 53% (95% CI, 40-65%), respectively. Surgical margins (SMs) were positive in 13% of the cases. Nodal metastases were detected in 3% of the patients after limited pelvic lymph node dissection (PLND) and in 10% after a standard PLND (p < 0.001). The 3-yr PFP for node-positive patients was 49%. There were 22 overall deaths and 2 deaths from prostate cancer. Conclusions: LRP provided 5- and 8-yr cancer control in 78% and 71% of patients, respectively, with clinically localized prostate cancer and in 53% of those with high-risk cancer at 5 yr. A PLND limited to the external iliac nodal group is inadequate for detecting nodal metastases. © 2008 European Association of Urology.
Keywords: immunohistochemistry; adult; aged; disease-free survival; middle aged; survival analysis; surgical technique; retrospective studies; major clinical study; overall survival; disease course; cancer growth; cancer risk; united states; cancer staging; outcome assessment; follow-up studies; lymph node metastasis; lymph node dissection; lymph nodes; neoplasm staging; laparoscopy; laparoscopic surgery; prospective study; lymph node excision; prostate specific antigen; progression free survival; cohort studies; neoplasm recurrence, local; retrospective study; risk factor; cancer mortality; time factors; risk assessment; prostate cancer; postoperative complications; confidence intervals; prostate-specific antigen; prostatic neoplasms; cancer center; probability; prostatectomy; surgery; cancer control; nomogram; france; prostate neoplasm
Journal Title: European Urology
Volume: 55
Issue: 5
ISSN: 0302-2838
Publisher: Elsevier Science, Inc.  
Date Published: 2009-05-01
Start Page: 1014
End Page: 1019
Language: English
DOI: 10.1016/j.eururo.2008.10.036
PUBMED: 19013010
PROVIDER: scopus
PMCID: PMC2962532
Notes: --- - "Cited By (since 1996): 11" - "Export Date: 30 November 2010" - "CODEN: EUURA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Darren Jonathan Katz
    37 Katz
  2. Fernando Pablo Secin
    54 Secin
  3. Abdelkrim Karim Touijer
    190 Touijer
  4. Andrew J Vickers
    565 Vickers
  5. Angel M Cronin
    145 Cronin
  6. Victor Reuter
    921 Reuter
  7. Kinjal C Vora
    25 Vora
  8. Fernando J Bianco
    72 Bianco