Evaluation of Retropubic Radical Prostatectomy for Clinically Localized Prostate Cancer Cases
- Author:
Shintaro OONUKI
;
Joji YUASA
;
Mitsuko YASUDA
;
Shigeo ISAKA
- Publication Type:Journal Article
- From:Journal of the Japanese Association of Rural Medicine
2009;58(4):447-451
- CountryJapan
- Language:Japanese
-
Abstract:
Background: The preferred management of localized prostate cancer is yet to be known, due in large part to a paucity of randomized controlled trials comparing benefits and risks across primary treatment options, such as watchful waiting, radical prostatectomy, radiation therapy and androgen deprivation. Aim: We reviewed treatment outcomes of retropubic radical prostatectomy for clinically localized prostate cancer patients. Methods and Subjects: We examined 63 patients with localized prostate cancers who underwent retropubic radical prostatectomy from January 2001 to December 2006. Mean age was 67.5 (range: 52-79 ages). Preoperative clinical stages were T1c (21 cases), T2a (29 cases), and T2b (13 cases). Results: Mean operation time was 261 minutes (range 194-340 minutes). Mean bloodloss was 1,123ml (range 135-3,500ml). As for Gleason scores of prostatectomy specimens, 32 cases had 6 or less, 25 cases had 7 and 6 cases had 8 or more. Pathological diagnoses were pT2a (31 cases), pT2b (4 cases), pT3 (28 cases), pN1 (2cases). As a result, 35 cases (55.6%) were defined as “organ confined diseases (OCD)”. Early complications occurred 16 cases, including rectal injuries (2 cases), wounds infections (10 cases), anastomotic stricture (2 cases) and epididymitis (2 cases). Slight and mild urinary incontinence (need of two or more pads per day) were recognized in 15cases (24%) as a late complication 3 months after operation, in 2 cases (3.2%) after 1year. Nerve sparing radical prostatectomy was performed on 28 cases. Six of them could keep erectile function with support of Phosphodiesterase type 5 (PDE-5) inhibitors. Biochemical recurrences were found in 12 cases, so that hormonal therapy was initiated as secondary cancer treatment. We investigated the predictors of PSA recurrence, and the OCD was a significant indicator for biochemical recurrence.
