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Radical Prostatectomy for the Treatment of Localized Prostatic Cancer

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A Multidisciplinary Analysis of Controversies in the Management of Prostate Cancer

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Abstract

The indications for radical prostatectomy must reflect: an understanding of the natural history of the disease, the projected life span of the patient, the stage of the disease, and the relative morbidity and efficacy of alternative therapeutic regimens. The integration of clinical stage, histologic grade, and pelvic lymph node evaluation has improved the selection of the ideal candidate for radical prostatectomy. In men with localized disease, there is no evidence that any treatment other than radical prostatectomy produces better control of the primary lesion and of distant metastases than does total surgical excision of the prostate. Recently the morbidity of radical prostatectomy has been reduced by improvements in surgical technique. Intraoperative identification and preservation of the branches of the pelvic plexus that innervate the corpora cavernosa has resulted in long-term postoperative potency rates of 72 percent without compromising complete excision of the tumor. Thus it appears possible today to preserve sexual function in a majority of patients undergoing radical prostatectomy without compromising the cancer operation, an observation that should encourage more physicians to take greater interest in diagnosing prostatic cancer at a stage when it is still curable.

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Authors and Affiliations

  1. Department of Urology, James Buchanan Brady Urological Institute, The Johns Hopkins University and Hospital, Baltimore, Maryland, USA

    Patrick C. Walsh M.D., Joseph E. Oesterling M.D. & Herbert Lepor M.D.

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  1. Patrick C. Walsh M.D.
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  2. Joseph E. Oesterling M.D.
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  3. Herbert Lepor M.D.
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Editors and Affiliations

  1. Johns Hopkins University and Hospital, Baltimore, Maryland, USA

    Donald S. Coffey

  2. University Hospitals of Cleveland, Cleveland, Ohio, USA

    Martin I. Resnick

  3. National Cancer Institute, Bethesda, Maryland, USA

    F. Andrew Dorr

  4. Roswell Park Memorial Institute, Buffalo, New York, USA

    James P. Karr

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© 1988 Plenum Press, New York

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Walsh, P.C., Oesterling, J.E., Lepor, H. (1988). Radical Prostatectomy for the Treatment of Localized Prostatic Cancer. In: Coffey, D.S., Resnick, M.I., Dorr, F.A., Karr, J.P. (eds) A Multidisciplinary Analysis of Controversies in the Management of Prostate Cancer. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1667-1_11

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  • DOI: https://doi.org/10.1007/978-1-4613-1667-1_11

  • Publisher Name: Springer, Boston, MA

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  • Online ISBN: 978-1-4613-1667-1

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