Short Term Outcomes in Indian Patients with High Risk Prostate Cancer after Laparoscopic Radical Prostatectomy- Data from a Single Institute
Background Management of high risk prostate cancer (HRPC) is in evolving stage. Effectiveness of the various treatment strategies is being explored. We examined the short term efficacy of laparoscopic radical prostatectomy (LRP) in treatment of patients with HRPC. Methods Retrospective observationa...
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| Format: | Article |
| Language: | English |
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Asian Medical Press Ltd.(H.K.)
2020-10-01
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| Series: | Annals of Urologic Oncology |
| Subjects: | |
| Online Access: | http://auo.asmepress.com/articles/new-35-771.html |
| _version_ | 1818555338643734528 |
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| author | Prashant Patel Shrenik J Shah Arpan Choudhary |
| author_facet | Prashant Patel Shrenik J Shah Arpan Choudhary |
| author_sort | Prashant Patel |
| collection | DOAJ |
| description | Background Management of high risk prostate cancer (HRPC) is in evolving stage. Effectiveness of the various treatment strategies is being explored. We examined the short term efficacy of laparoscopic radical prostatectomy (LRP) in treatment of patients with HRPC.
Methods Retrospective observational study had 140 HRPC patients of Indian origin, based on D’Amico classification system. Baseline workup was completed. Perioperative parameters and pathological findings were recorded. Multivariate analysis was performed to find predictive factors of pathological stage and PSM. 5 year biochemical recurrence free survival (BCRFS), cancer specific survival (CSS) and overall survival (OS) were calculated.
Results Mean age and PSA were 67.24±7.37 years and 23.29 ng/ml respectively. Three fourth of patients had a biopsy GS ≥8. 53.6% of patients were of clinical stage (CS) ≤T2; while 46.4% were of stage ≥T3. Conversion to open surgery rate was 15%. Mean operative time was 210 minutes; blood loss 230 ml; hospital stay 3 days; catheterization time 14 days; grade II or more complication rate 22.1%; LN positivity 20.0%; PSM rate 25.7%; upstaging 35.7%; down-staging 14.3%; pT2 31.4%; pT3a 26.4%; pT3b 42.2%. GS and CS were predictive of pathological stage and PSM respectively. 89.3% of cases were continent postoperatively. 5 year BCRFS, CSS and OS were 68.3%, 89.2% and 78.7% respectively.
Conclusions LRP is feasible and effective initial treatment for HRPC. Perioperative morbidity is acceptable. Accurate staging helps in better planning of the adjuvant therapy. Good short term survival can be achieved with multimodal therapy. |
| first_indexed | 2024-12-12T09:52:04Z |
| format | Article |
| id | doaj.art-8115c17520ae46ad9dc8c6ae0c3b34ee |
| institution | Directory Open Access Journal |
| issn | 2617-7765 2617-7773 |
| language | English |
| last_indexed | 2024-12-12T09:52:04Z |
| publishDate | 2020-10-01 |
| publisher | Asian Medical Press Ltd.(H.K.) |
| record_format | Article |
| series | Annals of Urologic Oncology |
| spelling | doaj.art-8115c17520ae46ad9dc8c6ae0c3b34ee2022-12-22T00:28:15ZengAsian Medical Press Ltd.(H.K.)Annals of Urologic Oncology2617-77652617-77732020-10-0110.32948/auo.2020.09.29Short Term Outcomes in Indian Patients with High Risk Prostate Cancer after Laparoscopic Radical Prostatectomy- Data from a Single InstitutePrashant Patel0Shrenik J Shah1 Arpan Choudhary2Department of Urology, Super specialty Hospital NSCB Medical College, Madhya Pradesh Medical Science University, Jabalpur 482003, India.Department of Urology, B.J. Medical College and Civil Hospital, Gujarat University, Ahmedabad 380016, India.Department of Urology, Super specialty Hospital NSCB Medical College, Madhya Pradesh Medical Science University, Jabalpur 482003, India.Background Management of high risk prostate cancer (HRPC) is in evolving stage. Effectiveness of the various treatment strategies is being explored. We examined the short term efficacy of laparoscopic radical prostatectomy (LRP) in treatment of patients with HRPC. Methods Retrospective observational study had 140 HRPC patients of Indian origin, based on D’Amico classification system. Baseline workup was completed. Perioperative parameters and pathological findings were recorded. Multivariate analysis was performed to find predictive factors of pathological stage and PSM. 5 year biochemical recurrence free survival (BCRFS), cancer specific survival (CSS) and overall survival (OS) were calculated. Results Mean age and PSA were 67.24±7.37 years and 23.29 ng/ml respectively. Three fourth of patients had a biopsy GS ≥8. 53.6% of patients were of clinical stage (CS) ≤T2; while 46.4% were of stage ≥T3. Conversion to open surgery rate was 15%. Mean operative time was 210 minutes; blood loss 230 ml; hospital stay 3 days; catheterization time 14 days; grade II or more complication rate 22.1%; LN positivity 20.0%; PSM rate 25.7%; upstaging 35.7%; down-staging 14.3%; pT2 31.4%; pT3a 26.4%; pT3b 42.2%. GS and CS were predictive of pathological stage and PSM respectively. 89.3% of cases were continent postoperatively. 5 year BCRFS, CSS and OS were 68.3%, 89.2% and 78.7% respectively. Conclusions LRP is feasible and effective initial treatment for HRPC. Perioperative morbidity is acceptable. Accurate staging helps in better planning of the adjuvant therapy. Good short term survival can be achieved with multimodal therapy.http://auo.asmepress.com/articles/new-35-771.htmlhigh risk prostate cancerlaparoscopic radical prostatectomybiochemical recurrence |
| spellingShingle | Prashant Patel Shrenik J Shah Arpan Choudhary Short Term Outcomes in Indian Patients with High Risk Prostate Cancer after Laparoscopic Radical Prostatectomy- Data from a Single Institute Annals of Urologic Oncology high risk prostate cancer laparoscopic radical prostatectomy biochemical recurrence |
| title | Short Term Outcomes in Indian Patients with High Risk Prostate Cancer after Laparoscopic Radical Prostatectomy- Data from a Single Institute |
| title_full | Short Term Outcomes in Indian Patients with High Risk Prostate Cancer after Laparoscopic Radical Prostatectomy- Data from a Single Institute |
| title_fullStr | Short Term Outcomes in Indian Patients with High Risk Prostate Cancer after Laparoscopic Radical Prostatectomy- Data from a Single Institute |
| title_full_unstemmed | Short Term Outcomes in Indian Patients with High Risk Prostate Cancer after Laparoscopic Radical Prostatectomy- Data from a Single Institute |
| title_short | Short Term Outcomes in Indian Patients with High Risk Prostate Cancer after Laparoscopic Radical Prostatectomy- Data from a Single Institute |
| title_sort | short term outcomes in indian patients with high risk prostate cancer after laparoscopic radical prostatectomy data from a single institute |
| topic | high risk prostate cancer laparoscopic radical prostatectomy biochemical recurrence |
| url | http://auo.asmepress.com/articles/new-35-771.html |
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