LRP Suitable for High-Risk Prostate Cancer

High-risk patients treated with laparoscopic RP have a low risk of post-operative complications.
High-risk patients treated with laparoscopic RP have a low risk of post-operative complications.

ORLANDO—High-risk prostate cancer (HRPC) patients treated with laparoscopic radical prostatectomy (LRP) have a low risk of post-operative complications, according to a study presented at the American Urological Association 2014 annual meeting.

Antonina di Benedetto, MD, of  The Royal Surrey County Hospital in Guildford, U.K., looked at 446 high-risk patients from 2000–2013 to study the effects of LRP. Median age was 64 years with a PSA of 8.1 ng/mL and Gleason score of 8. All patients were staged by preoperative magnetic resonance imaging and isotope bone scanning.

With a median follow-up of 24.9 months, 79.2% of patients had no biochemical recurrence, 91.8% were continent, and 64.4% of previous potent non-diabetic men younger than 70 years were potent after bilateral nerve preservation.

The overall complication rate was 7.6%, and no cases had to be converted to open surgery. The average blood loss was 200 mL (10–1,400 mL), and average hospital stay was 3 nights (2 to 7).

The researchers concluded that their study “should serve to encourage experienced urologists to offer radical prostatectomy to patients with HRPC knowing that interpretation of their oncological status is simpler following surgery and that radiotherapy and hormonal manipulation have been kept in reserve if and when they are needed.” 

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