BERLIN, GERMANY (UroToday.com) - EAU 2007 - A session on "Open and Laparoscopic Radical Prostatectomy Tumors" took place at the EAU on Friday March 23, 2007. Two talks from this session are covered herein.

Dr. Touijer, New York, USA presented "Comparative Analysis of the Impact of Prostate Volume on Positive Surgical Margin Incidence and Location between Open and Laparoscopic Radical Prostatectomy". The goal was to assess prostate weight in correlation with positive surgical margin (PSM) incidence, and location in patients undergoing either lap or open RP at Memorial Sloan Kettering Cancer Center. During the time 2002-2005, 527 patients underwent lap RP and 860 underwent open RP. PSM was diagnosed when tumor cells were present at the inked margin. In lap and open RP, one or more PSMs were found in 11% and 11.3%, respectively. After adjusting for other clinical and pathologic variables, PSM was associated with smaller prostate volume. Interestingly, in prostate volumes less than 30gm, lap RP was associated with a PSM in 44%, while no such association existed for open RP. Six of 8 PSMs in this prostate size range were found at the apex of the prostate. Dr. Guillonneau's technique is undergoing technical modifications to minimize this PSM rate.

In another presentation by Dr. Touijer, non-randomized RP outcomes between lap and open RP were made. The patient groups consisted of 613 consecutive lap patients and 818 open RP patients. Functional outcomes were assessed by a patient completed health related QoL survey. The number of lymph nodes obtained, the metastatic lymph node rate and PSM rates were similar among the two groups. The 12 month biochemical recurrence data was also similar. Following a bilateral nerve-sparing procedure, potency rates at 14 months were similar at 76-78% and 90-92% of patients were similarly continent. Lap RP had a lower mean blood loss (314ml) compared to open RP (1,267ml) and overall transfusion rate (3% vs. 49%). Other complications were not different. The lap RP patients had greater ER visits and readmission rates (16% vs. 11% and 5% vs. 1%, respectively) than open RP. While non-randomized, these data exemplify some of the similarities and differences of these two surgical approaches at a high volume tertiary cancer center.

EAU 2007 Conference Coverage on UroToday.com

Please log-in or register in order to submit comments.

Powered by AkoComment!