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Midterm oncological outcomes of laparoscopic vs open radical prostatectomy ( RP )
Author(s) -
Wirth Gregory J.,
Psutka Sarah P.,
Chapin Brian F.,
Wu Shulin,
Wu ChinLee,
Dahl Douglas M.
Publication year - 2013
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12085
Subject(s) - biochemical recurrence , medicine , prostatectomy , pathological , radical retropubic prostatectomy , pathological staging , urology , surgery , breakpoint cluster region , open surgery , laparoscopic radical prostatectomy , laparoscopy , prostate cancer , cancer , receptor
Objective To compare the midterm risks of biochemical recurrence ( BCR ) and salvage radiation therapy ( SRT ) after laparoscopic ( LRP ) and open retropubic radical prostatectomy ( RRP ). Strong evidence that these techniques are comparable to the ‘gold standard’ of open RRP is lacking, as most comparative studies are limited by short follow‐up or rely on historical controls.Patients and Methods We studied 1000 consecutive patients concurrently treated by either LRP or RRP between 2001 and 2005. LRPs were performed by a single surgeon and RRP by four surgeons. Primary outcomes were BCR and SRT . Survival analysis included relevant clinical and pathological variables.Results Of 844 included patients, 244 underwent LRP and 600 RRP . Clinical and pathological characteristics were similar in both groups. Most patients had G leason 6 tumours (68%) and pT2 disease (86%). The median follow‐up was 6.1 years and median time to recurrence 3.4 years. Overall, BCR occurred in 14% of patients: 13.1% after LRP and 14.7% after RRP . SRT was performed in 10.7% of patients both after LRP and RRP . In uni‐ and multivariate C ox regression models, surgical technique was not a significant predictor of BCR or SRT .Conclusion Our results suggest that in high‐volume centres, LRP provides equivalent oncological control to RRP .