Oncologic Outcome following Laparoscopic Radical Prostatectomy and the Difference in Oncologic Outcomes according to the Site of the Positive Margin: Comparison of the Apical Positive Margin with the Non-Apical Positive Margin.
10.4111/kju.2009.50.10.955
- Author:
U Syn HA
1
;
Sung In KIM
;
Su Jin KIM
;
Hyuk Jin CHO
;
Sung Hoo HONG
;
Ji Youl LEE
;
Joon Chul KIM
;
Sae Woong KIM
;
Tae Kon HWANG
Author Information
1. Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea. tkhwang@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Prostatectomy;
Recurrence;
Laparoscopy
- MeSH:
Humans;
Laparoscopy;
Male;
Prostate-Specific Antigen;
Prostatectomy;
Recurrence
- From:Korean Journal of Urology
2009;50(10):955-962
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The aim of this study was to analyze oncologic outcomes based on 7 years of consecutive experience with laparoscopic radical prostatectomy (LRP) and to assess the prognostic difference between an apical positive margin and a non-apical positive margin. MATERIALS AND METHODS: We reviewed 202 patients who underwent LRP between July 2001 and July 2007 (pathologic stage: T2-T3b, without any adjunctive therapy). Biochemical recurrence (bR) was defined as two consecutive prostate-specific antigen (PSA) values greater than 0.2 ng/ml. We analyzed the differences in bR among the negative margin group (N), the apical positive margin group (A), and the non-apical positive margin group (NA) and factors predicting bR. RESULTS: Overall 3-year probability of bR-free survival (bRFS) was 78% (pT2, 83.7%; pT3, 60.9%). For low-, intermediate-, and high-risk cancer, 3-year bRFS was 94.7%, 82.8%, and 60.7%, respectively. Of the 155 men who had negative and single-site positive margins, the numbers in the N, A, and NA groups were 108, 19, and 28, respectively. bR rates for the N, A, and NA groups were 14.8%, 36.8%, and 46.4%, respectively. Kaplan-Meier curves showed that a positive surgical margin had a significant higher bR compared with the N group; however, the A group experienced a similar bRFS compared with the NA group (p=0.613). Multivariate Cox proportional hazards analysis indicated no significant difference of effect on time to bR between the A and NA groups (hazard ratio=1.213; 95% confidence interval: 0.482-3.052). CONCLUSIONS: Our results were almost identical to previous reports of radical prostatectomy in pT2 disease. With increasing experience, we could expect improved oncologic outcomes. In comparison with the NA group, the A group did not show a significant prognostic difference.
