UroToday - Presented Monday, 03 September 2007 at the 29th Congress of the Societe International d'Urologie - SIU 2007 - Optimizing Clinical Outcomes in Prostate and Renal Cell Carcinomas - The Second Annual Symposium on Advanced GU Malignancy - Palais des Congres de Paris, France

Introduction and Objectives: Laparoscopic radical prostatectomy (LRP) continues to develop as a minimally invasive alternative to open radical prostatectomy. We present the results of the first 100 cases performed in the UK with a minimum of five years follow-up.

Material and Methods: 100 patients underwent transperitoneal LRP performed by a single surgeon during a 25 month period from 2000-2002. Mean age was 62 years (range 52-72). Most (78%) patients had a PSA between 4 and 10, clinical stage T1 disease (62%), and Gleason 6 on biopsy (50%). Sixty-four percent of patients underwent unilateral or bilateral nerve preservation and 14% had pelvic lymphadenectomy performed.

Results: Mean operating time was 245 minutes, with a 1% conversion rate. Three percent of patients received a blood transfusion and 3% had major complications, including a rectal injury. The positive margin rate was 16% and correlated with pathological parameters. At a minimum of 5 years follow-up (mean = 5.7 years) overall survival was 99% and biochemical progression-free survival was 86% in all patients: 89.3% for pT2, and 73% for pT3. Ninety percent of patients used 0-1 pads/ day (84% pad-free) and 60% of patients undergoing nerve preservation retained erectile function.

Conclusions: This series represents the first 5-year minimum follow-up results for LRP performed in the UK, with morbidity and functional and oncological results which are comparable to previously published open radical prostatectomy (ORP) series. The ORP literature suggests that as the technique of LRP evolves and experience with it grows that these results are likely to be surpassed.

Authors: Merilees D, Chabert C, Eden C

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