Laparoscopic Radical Prostatectomy in Patients with High-Risk Prostate Cancer: Feasibility and Safety. Results of a Multicentric Study

Varca, Virginia; Benelli, Andrea; Perri, Davide; Gözen, A.S.; Fiedler, Marcel; Taille, Alexandre de la; Casazza, Giovanni; Salomon, Laurent; Rassweiler, Jens; Gregori, Andrea; Gaboardi, Franco

doi:10.1089/end.2018.0086

Cited by 5 publications

(12 citation statements)

References 26 publications

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“…Similarly the distribution of biopsy GS was variable. A score below 8 in more than half of the cases was reported by few authors [11,14,16,18,19]; while a score of 8 or more was noted by others, including us [5,10,17]. However, patient's clinical stage in our study was similar to the other reports.…”

Section: Discussionsupporting

confidence: 84%

“…PSA distribution among the various other studies of HRPC treatment by RP was not uniform ( Table 5). Mean PSA around 10ng/ml was found in a few studies [7,10,14,15,16,17] while a value between 15-25ng/ml was observed in others, including in our study [5,11,18,19]. Similarly the distribution of biopsy GS was variable.…”

Section: Discussioncontrasting

confidence: 43%

“…Encouraged from the results of RP in localized disease, RP is now being utilized with greater frequency in high risk disease also [9]. Many authors have reported a decent short and long term results in HRPC, treated with RP as a part of multimodal therapy [10,11]. Few studies have even shown the superiority of RP over RT for HRPC [12,13].…”

Section: Discussionmentioning

confidence: 99%

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Short Term Outcomes in Indian Patients with High Risk Prostate Cancer after Laparoscopic Radical Prostatectomy- Data from a Single Institute

Patel¹,

Shah²

2020

ann urol oncol

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Background Management of high risk prostate cancer (HRPC) is in evolving stage. Effectiveness of the various treatment strategies is being explored. We examined the short term efficacy of laparoscopic radical prostatectomy (LRP) in treatment of patients with HRPC. Methods Retrospective observational study had 140 HRPC patients of Indian origin, based on D’Amico classification system. Baseline workup was completed. Perioperative parameters and pathological findings were recorded. Multivariate analysis was performed to find predictive factors of pathological stage and PSM. 5 year biochemical recurrence free survival (BCRFS), cancer specific survival (CSS) and overall survival (OS) were calculated. Results Mean age and PSA were 67.24±7.37 years and 23.29 ng/ml respectively. Three fourth of patients had a biopsy GS ≥8. 53.6% of patients were of clinical stage (CS) ≤T2; while 46.4% were of stage ≥T3. Conversion to open surgery rate was 15%. Mean operative time was 210 minutes; blood loss 230 ml; hospital stay 3 days; catheterization time 14 days; grade II or more complication rate 22.1%; LN positivity 20.0%; PSM rate 25.7%; upstaging 35.7%; down-staging 14.3%; pT2 31.4%; pT3a 26.4%; pT3b 42.2%. GS and CS were predictive of pathological stage and PSM respectively. 89.3% of cases were continent postoperatively. 5 year BCRFS, CSS and OS were 68.3%, 89.2% and 78.7% respectively. Conclusions LRP is feasible and effective initial treatment for HRPC. Perioperative morbidity is acceptable. Accurate staging helps in better planning of the adjuvant therapy. Good short term survival can be achieved with multimodal therapy.

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Section: Discussionsupporting

confidence: 84%

Section: Discussioncontrasting

confidence: 43%

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Short Term Outcomes in Indian Patients with High Risk Prostate Cancer after Laparoscopic Radical Prostatectomy- Data from a Single Institute

Patel¹,

Shah²

2020

ann urol oncol

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“…Because of the familiar route and reliable touch [ 12 ], ORP has always been the “gold standard” treatment for PCa [ 13 ], but since 1991, LRP for PCa treatment has been widely disseminated in an attempt to decrease morbidity compared with the traditional ORP [ 14 ], even though with high-risk PCa patients [ 15 ]. With the improvement of the modern technology and the advent of robotic instruments, RARP was promptly applied in the USA and some developed European countries as the most common extirpative treatment for PCa [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

A novel “three-port” trocar placement technique for laparoscopic radical prostatectomy

Peng

et al. 2020

World J Surg Onc

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Background To introduce a novel “three-port” trocar placement technique for laparoscopic radical prostatectomy (LRP) in prostate cancer (PCa) patients. Methods We retrospectively reviewed 300 patients with PCa who received surgical treatment between November 2010 and June 2015 at our institution. They were divided into group A, three-port LRP; group B, conventional four-five-port LRP; group C, open RP (ORP); and group D, robotic-assisted RP (RARP). A learning curve was analyzed by dividing patients of group A into the early and late stages. Results All groups were comparable with regard to the preoperative characteristics except for the relatively smaller prostate volume in group A. The three-port LRP operations were performed successfully with only 8 cases of conversion to the conventional LRP. None of any severe complications or conversion to ORP occurred. In group A, the mean operative time (OT) duration was 113.8 min, the mean estimated blood loss (EBL) was 94.2 ml, the mean drainage days was 4.0 days, the mean hospitalization was 5.1 days, and 27.8% of the prostate specimen margins (PSM) were positive. The differences of OT, EBL, drainage days, hospitalization, and transfusion in group A were statistically significant among the majority of the other groups (p < 0.05). After undergoing the early stages of a learning curve analysis in three-port LRP, the EBL was obviously decreased. Conclusions Three-port LRP is a novel technique that exhibits superior intraoperative advantages to the conventional LRP. Due to its less OT, EBL, drainage days, hospitalization, and transfusion with a shorter learning curve, it should be recommended and popularized in the clinical practice.

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“…Because of the familiar route and reliable touch [12] , ORP has always been the "gold standard" treatment for PCa [13] but since 1991, LRP for PCa treatment has been widely disseminated in an attempt to decrease morbidity compared with the traditional ORP [14] , even though with high-risk PCa patients [15] . With the improvement of the modern technology and the advent of robotic instruments, RARP was promptly applied in the United States and some developed European countries as the most common extirpative treatment for PCa [16] .…”

Section: Discussionmentioning

confidence: 99%

A novel “Three-port” trocar placement technique for laparoscopic radical prostatectomy

Peng

et al. 2020

Preprint

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Background: To introduce a novel “three-port” trocar placement technique for laparoscopic radical prostatectomy (LRP) in prostate cancer (PCa) patients.Methods: We retrospectively reviewed 300 patients with PCa who received surgical treatment between November 2010 and June 2015 at our institution. They were divided into group A: three-port LRP, group B: conventional four-five port LRP, group C: open RP (ORP) and group D: robotic-assisted RP (RARP). A learning curve was analyzed by dividing patients of group A into the early and late stages.Results: All groups were comparable with regard to the preoperative characteristics except for the relatively smaller prostate volume in group A. The three-port LRP operations were performed successfully with only 8 cases conversion to the conventional LRP. None of any severe complications or conversion to ORP occurred. In group A, the mean operative time (OT) duration was 113.8min, the mean estimated blood loss (EBL) was 94.2ml, the mean drainage days was 4.0d, the mean hospitalization was 5.1d, and 27.8% of the prostate specimen margins (PSM) were positive. The differences of OT, EBL, drainage days, hospitalization and transfusion in group A were statistically significant among the majority of the other groups (p<0.05). After undergoing the early stages of a learning curve analysis in three-port LRP, the EBL was obviously decreased.Conclusions: Three-port LRP is a novel technique that exhibits superior intraoperative advantages to the conventional LRP. Due to its less OT, EBL, drainage days, hospitalization and transfusion with a shorter learning curve, it should be recommended and popularized in the clinical practice!

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Laparoscopic Radical Prostatectomy in Patients with High-Risk Prostate Cancer: Feasibility and Safety. Results of a Multicentric Study

Abstract: According to our encouraging data about oncological and functional outcomes we believe that radical prostatectomy represents an effective treatment for patients with high-risk PCa and that laparoscopy is a safe approach offering a mini-invasive alternative to open surgery.

Cited by 5 publications

References 26 publications

Short Term Outcomes in Indian Patients with High Risk Prostate Cancer after Laparoscopic Radical Prostatectomy- Data from a Single Institute

Short Term Outcomes in Indian Patients with High Risk Prostate Cancer after Laparoscopic Radical Prostatectomy- Data from a Single Institute

A novel “three-port” trocar placement technique for laparoscopic radical prostatectomy

A novel “Three-port” trocar placement technique for laparoscopic radical prostatectomy

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