Is Radical Perineal Prostatectomy a Viable Therapeutic Option for Intermediate- and High-risk Prostate Cancer?

The aim of this study was to investigate a single-institution experience with radical perineal prostatectomy (RPP), radical retropubic prostatectomy (RRP) and minimally invasive radical prostatectomy (MIRP) with respect to onco-surgical outcomes in patients with intermediate-risk (IR; PSA 10-20 ng/mL, biopsy Gleason score bGS 7 or cT2b-2c) and high-risk (HR; PSA >20 ng/mL, bGS ≥8, or ≥cT3) prostate cancer (PCa).

We retrospectively reviewed data from 2,581 men who underwent radical prostatectomy for IR and HR PCa (RPP, n = 689; RRP, n = 402; MIRP, n = 1,490 [laparoscopic, n = 206; robot-assisted laparoscopic, n = 1,284]). The proportion of HR PCa was 40. 3%, 46. 8%, and 49. 5% in RPP, RRP, and MIRP (P < 0. 001), respectively. The positive surgical margin rate was 23. 8%, 26. 1%, and 18. 7% (P = 0. 002) overall, 17. 5%, 17. 8%, and 8. 8% (P < 0. 001) for pT2 disease and 41. 9%, 44. 4%, and 40. 0% (P = 0. 55) for pT3 disease in men undergoing RPP, RRP, and MIRP, respectively. Biochemical recurrence-free survival rates among RPP, RRP, and MIRP were 73. 0%, 70. 1%, and 76. 8%, respectively, at 5 yr (RPP vs. RPP, P = 0. 02; RPP vs. MIRP, P = 0. 23). Furthermore, comparable 5-yr metastases-free survival rates were demonstrated for specific surgical approaches (RPP vs. RPP, P = 0. 26; RPP vs. MIRP, P = 0. 06). RPP achieved acceptable oncological control for IR and HR PCa.

Journal of Korean medical science. 2015 Oct 16 [Epub]

Hye Won Lee, Hwang Gyun Jeon, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Hyun Moo Lee, Han Yong Choi

Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ; Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. , Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. , Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. , Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. , Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. , Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. , Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

PubMed      Full Text Aritcle

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