Contemporary Radical Prostatectomy

Abstract

Purpose. Patients diagnosed with clinically localized prostate cancer have more surgical treatment options than in the past. This paper focuses on the procedures' oncological or functional outcomes and perioperative morbidities of radical retropubic prostatectomy, radical perineal prostatectomy, and robotic-assisted laparoscopic radical prostatectomy. Materials and Methods. A MEDLINE/PubMed search of the literature on radical prostatectomy and other new management options was performed. Results. Compared to the open procedures, robotic-assisted radical prostatectomy has no confirmed significant difference in most literatures besides less blood loss and blood transfusion. Nerve sparing is a safe means of preserving potency on well-selected patients undergoing radical prostatectomy. Positive surgical margin rates of radical prostatectomy affect the recurrence and survival of prostate cancer. The urinary and sexual function outcomes have been vastly improved. Neoadjuvant treatment only affects the rate of positive surgical margin. Adjuvant therapy can delay and reduce the risk of recurrence and improve the survival of the high risk prostate cancer. Conclusions. For the majority of patients with organ-confined prostate cancer, radical prostatectomy remains a most effective approach. Radical perineal prostatectomy remains a viable approach for patients with morbid obesity, prior pelvic surgery, or prior pelvic radiation. Robot-assisted laparoscopic prostatectomy (RALP) has become popular among surgeons but has not yet become the firmly established standard of care. Long-term data have confirmed the efficacy of radical retropubic prostatectomy with disease control rates and cancer-specific survival rates.

Disease Progression/Clinical Outcome Model for Castration‐Resistant Prostate Cancer in Patients Treated With Eribulin

“…Prostate cancer (PC) is one of the most common malignancies in men in Europe and the United States . Local PC is potentially curable with radiation therapy, hormone therapy, and/or radical prostectomy . However, up to 40% of the patients who are diagnosed with localized disease ultimately develop advanced PC, even after initial treatment of local disease .…”

Open Radical Retropubic Prostatectomy as a Saviour in the Era of Robotics- A Single Surgeon Experience

“…Although robotic assisted radical prostatectomy is being most commonly performed in developed countries but as for as the trifecta of the surgery is concerned robotic as well as the RPP techniques have yielded equivalent effectiveness rates of functional, oncological, and surgical outcomes [14]. Infact many studies have shown RPP as a minimally invasive procedure that was found to be the most costeffective [15,16,17,18]. Success of open radical prostatectomy has improved with clear understanding of periprostatic anatomy.…”

UROLOGICAL ONCOLOGY Radical perineal prostatectomy – the contemporary resurgence of a genuinely minimally invasive procedure: Procedure outline. Comparison of the advantages, disadvantages, and outcomes of different surgical techniques of treating organ-confined prostate cancer (PCa). A literature review with special focus on perineal prostatectomy

“…The same indications apply to retropubic (RRP), laparoscopic (LRP), and robot-assisted radical prostatectomies (RARP), all of which can be categorized into one coherent “retropubic complex”, and radical perineal prostatectomy (RPP) as a distinct kind of procedure [ 3 , 4 , 8 , 14 ]. The differences among these procedures reside in the access to the prostate, as all procedures result the same with no significant superiority [ 3 , 8 , 12 , 14 – 20 ]. The current trend towards ‘minimalism’, however, should not challenge the principles of radical prostatectomy.…”