Is Radical Perineal Prostatectomy a Viable Therapeutic Option for Intermediate- and High-risk Prostate Cancer?.
10.3346/jkms.2015.30.11.1631
- Author:
Hye Won LEE
1
;
Hwang Gyun JEON
;
Byong Chang JEONG
;
Seong Il SEO
;
Seong Soo JEON
;
Hyun Moo LEE
;
Han Yong CHOI
Author Information
1. Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hanchoi@skku.edu
- Publication Type:Original Article
- Keywords:
Prostatic Neoplasms;
Radical Prostatectomy;
Risk Assessment;
Minimally Invasive Surgical Procedures;
Treatment Outcome
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Disease-Free Survival;
Humans;
Laparoscopy/*utilization;
Male;
Middle Aged;
Minimally Invasive Surgical Procedures/*utilization;
Perineum/*surgery;
Prevalence;
Prostatectomy/*utilization;
Prostatic Neoplasms/diagnosis/*epidemiology/*surgery;
Republic of Korea/epidemiology;
Retrospective Studies;
Risk Factors;
Treatment Outcome
- From:Journal of Korean Medical Science
2015;30(11):1631-1637
- CountryRepublic of Korea
- Language:English
-
Abstract:
The aim of this study was to investigate a single-institution experience with radical perineal prostatectomy (RPP), radical retropubic prostatectomy (RRP) and minimally invasive radical prostatectomy (MIRP) with respect to onco-surgical outcomes in patients with intermediate-risk (IR; PSA 10-20 ng/mL, biopsy Gleason score bGS 7 or cT2b-2c) and high-risk (HR; PSA >20 ng/mL, bGS > or =8, or > or =cT3) prostate cancer (PCa). We retrospectively reviewed data from 2,581 men who underwent radical prostatectomy for IR and HR PCa (RPP, n = 689; RRP, n = 402; MIRP, n = 1,490 [laparoscopic, n = 206; robot-assisted laparoscopic, n = 1,284]). The proportion of HR PCa was 40.3%, 46.8%, and 49.5% in RPP, RRP, and MIRP (P < 0.001), respectively. The positive surgical margin rate was 23.8%, 26.1%, and 18.7% (P = 0.002) overall, 17.5%, 17.8%, and 8.8% (P < 0.001) for pT2 disease and 41.9%, 44.4%, and 40.0% (P = 0.55) for pT3 disease in men undergoing RPP, RRP, and MIRP, respectively. Biochemical recurrence-free survival rates among RPP, RRP, and MIRP were 73.0%, 70.1%, and 76.8%, respectively, at 5 yr (RPP vs. RPP, P = 0.02; RPP vs. MIRP, P = 0.23). Furthermore, comparable 5-yr metastases-free survival rates were demonstrated for specific surgical approaches (RPP vs. RPP, P = 0.26; RPP vs. MIRP, P = 0.06). RPP achieved acceptable oncological control for IR and HR PCa.
