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Long-term oncological and functional results of extraperitoneal laparoscopic radical prostatectomy: one surgical team’s experience on 1,600 consecutive cases

World Journal of Urology volume 31, pages 529–534 (2013)Cite this article

Abstract

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.

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Conflict of interest

All authors certify that there is no actual or potential conflict of interest in relation to this article and that there was no financial support for the present research.

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Authors and Affiliations

  1. Department of Urology, University of Naples Federico II, Naples, Italy

    Paolo Verze & Vincenzo Mirone

  2. Department of Urology, Azienda Ospedaliera Valtellina e Valchiavenna, Ospedale di Sondalo, Sondalo, Italy

    Salvatore Scuzzarella, Giorgio R. Martina, Pierluigi Giummelli & Federico Cantoni

Authors
  1. Paolo Verze
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  2. Salvatore Scuzzarella
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  3. Giorgio R. Martina
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  4. Pierluigi Giummelli
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  5. Federico Cantoni
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  6. Vincenzo Mirone
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Correspondence to Paolo Verze.

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Verze, P., Scuzzarella, S., Martina, G.R. et al. Long-term oncological and functional results of extraperitoneal laparoscopic radical prostatectomy: one surgical team’s experience on 1,600 consecutive cases. World J Urol 31, 529–534 (2013). https://doi.org/10.1007/s00345-013-1052-0

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