کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5730666 | 1411723 | 2017 | 5 صفحه PDF | دانلود رایگان |
ObjectiveAsian patients tend to have higher stage prostate cancer at diagnosis compared with patients of other races. This article aims to investigate the use of four-port extraperitoneal laparoscopic radical prostatectomy (EPLRP) as the first step in a multimodality treatment strategy for Asian patients with high-risk prostate cancer (HRPC).Materials and methodsA cohort of 202 patients underwent EPLRP between January 2006 to January 2016, of whom 122 (60.3%) had HRPC as defined by D'Amico classification: clinical T stage â¥Â cT2c or PSA level â¥Â 20 ng/mL or biopsy Gleason sum â¥Â 8). All patients underwent proper preoperative staging. The median age was 68 years (48-82), PSA level 17.8 ng/mL (3.3-191.1), and biopsy Gleason sum 7 (6-10). All patients underwent pelvic lymphadenectomy, and some underwent neurovascular bundle preservation according to their risk category.ResultsPerioperative outcomes included a median operative time of 185 min (65-380), total blood loss 150 ml (30-500), postoperative hospitalization 10 days (6-25), and urethral catheterization time 7 days (4-22). No patient was converted to open surgery. Median specimen weight was 42 g (19-124), lymph node yield was 10 (0-35) with 11.5% positivity and a positive surgical resection margin rate of 28.7%. The median follow-up period was 37 months (6-129). 96.7% of patients achieved continence and 53.8% of the 39 potent patients prior to surgery maintained their sexual potency at one year after EPLRP. The 5-year cancer-specific, overall, and biochemical recurrence-free survival rates were 98.8%, 92.2%, and 68.7%, respectively.ConclusionExtraperitoneal laparoscopic radical prostatectomy has low morbidity, and can provide fair functional and oncological outcomes as the first step of a multimodality treatment strategy for high-risk prostate cancer in Asian.
Journal: Urological Science - Volume 28, Issue 2, June 2017, Pages 66-70