PURPOSE: To determine the oncologic and functional outcomes of ELRP on a single surgical team's series. METHODS: A total of 1,600 consecutive ELRP patients were recorded with a 2-year follow-up. In 778 patients, a 5-year follow-up was available. RESULTS: The mean operative time was 125,6 min (PLND not included) and 150,9 min (PLND included). Postoperative stage was pT2a in 282 patients (17.6 %), pT2b in 877 (54.8 %), pT2c in 18 (1.1 %), pT3a in 241 (15 %), and pT3b in 182 (11.3 %). Positive margins were detected in 7.4 and 13.4 % of pT2 and pT3 tumors, respectively. Overall complication rate was 4 %. PSA levels resulted in <0.2 ng/mL in 96.4, 94.9, 92, 90.9, and 81.5 % of the cases at 3, 12, 24, 36, and 60 months after surgery, respectively. BCRFS rates 5 years after ELRP were 88.7 % for patients staged as pT2, 73.9 % for pT3a, and 62.4 % for pT3b. Complete urinary continence rate resulted in 39 and 92 % after 1 and 12 months, respectively, with a further increase from 92 to 98.4 % at 24-month follow-up. A nerve-sparing procedure was performed in 45 % of patients. The overall potency rate at 12-month follow-up was 38.67 % for UNSS patients and 75 % for BNSS patients. Potency recovery was age-dependent, with patients aged <55 years who resulted potent in 46.8 % of UNSS and 95.8 % of BNSS after 24 months. CONCLUSIONS: ELRP is a standardized and safe procedure that implies advantages of both minimally invasive and extraperitoneal approaches with elevated standards for oncologic and functional outcomes obtained at long-term follow-up.
PURPOSE: To determine the oncologic and functional outcomes of ELRP on a single surgical team's series. METHODS: A total of 1,600 consecutive ELRP patients were recorded with a 2-year follow-up. In 778 patients, a 5-year follow-up was available. RESULTS: The mean operative time was 125,6 min (PLND not included) and 150,9 min (PLND included). Postoperative stage was pT2a in 282 patients (17.6 %), pT2b in 877 (54.8 %), pT2c in 18 (1.1 %), pT3a in 241 (15 %), and pT3b in 182 (11.3 %). Positive margins were detected in 7.4 and 13.4 % of pT2 and pT3tumors, respectively. Overall complication rate was 4 %. PSA levels resulted in <0.2 ng/mL in 96.4, 94.9, 92, 90.9, and 81.5 % of the cases at 3, 12, 24, 36, and 60 months after surgery, respectively. BCRFS rates 5 years after ELRP were 88.7 % for patients staged as pT2, 73.9 % for pT3a, and 62.4 % for pT3b. Complete urinary continence rate resulted in 39 and 92 % after 1 and 12 months, respectively, with a further increase from 92 to 98.4 % at 24-month follow-up. A nerve-sparing procedure was performed in 45 % of patients. The overall potency rate at 12-month follow-up was 38.67 % for UNSS patients and 75 % for BNSS patients. Potency recovery was age-dependent, with patients aged <55 years who resulted potent in 46.8 % of UNSS and 95.8 % of BNSS after 24 months. CONCLUSIONS: ELRP is a standardized and safe procedure that implies advantages of both minimally invasive and extraperitoneal approaches with elevated standards for oncologic and functional outcomes obtained at long-term follow-up.
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Authors: Stênio de Cássio Zequi; Walter Henriques da Costa; Fernando Korkes; Rodolfo Borges Dos Reis; Wilson Francisco Schreiner Busato; Wagner Eduardo Matheus; Deusdedit Cortez Vieira da Silva Neto; Felipe de Almeida E Paula; Gustavo Franco Carvalhal; Lucas Nogueira; Roni de Carvalho Fernandes; Adriano Gonçalves E Silva; André Deeke Sasse; André P Fay; Denis Leonardo Jardim; Diogo Assed Bastos; Diogo Augusto Rodrigues da Rosa; Evanius Wierman; Fabio Kater; Fabio A Schutz; Fernando Cotait Maluf; Fernando Nunes Galvão de Oliveira; Igor Alexandre Protzner Morbeck; José Augusto Rinck; Karine Martins da Trindade; Manuel Caitano Maia; Vinicius Carrera Souza; Fernando Sabino Marques Monteiro; Andrey Soares Journal: Ther Adv Urol Date: 2019-09-09