4.1 Article

Open retropubic radical prostatectomy: Still a well-established surgical technique for prostate cancer management

Journal

ACTAS UROLOGICAS ESPANOLAS
Volume 47, Issue 3, Pages 172-178

Publisher

ELSEVIER ESPANA
DOI: 10.1016/j.acuro.2022.09.004

Keywords

Biochemical recurrence; Early continence; Open radical prostatectomy; Overall survival; Pad test; Prostate cancer

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The study aimed to evaluate the long-term oncological outcomes, complication rates, and early continence rates in patients treated with open retropubic radical prostatectomy (ORP). The results demonstrate that ORP is a surgical procedure that provides excellent oncological and early continence rates.
Introduction: The surgical treatment options for prostate cancer have changed rapidly, given the expansion of robotics. However, open retropubic radical prostatectomy (ORP) will continue to be performed in areas with financial limitations or with limited access to robotics. The purpose of this study was to determine the long-term oncological outcomes, to categorize complication rates and to examine the early continence rates in patients treated with ORP.Methods: We identified all patients who underwent ORP at our institution between 2000 and 2020. A standardized pad test was used to determine the early continence rates upon catheter removal, the late continence around a year after surgery was determined by the number of pads per day. The Clavien-Dindo classification was used to report the complication rates. The biochemical recurrence (BCR)-free survival and overall survival (OS) rates were defined using the Kaplan-Meier method and log-rank analysis. Multivariable Cox-regression models were used to test the effect of different factors on biochemical recurrence.Results: We analyzed 1095 patients. The median follow-up was 93.4 months. An overall 10-year BCR-free survival and OS of 73% and 82% respectively was found. A complication rate for Clavien Dindo >= 3 was seen in 4.8% of patients. The early continence rate was 81.4% and the late continence 89.1%. Preoperative PSA level, Gleason score sum, pT stage, lymph node status, and surgical margin status were independent predictors of BCR (P < .001). Limitations include retrospective and single centre study design.Conclusions: ORP is a surgical procedure that provides excellent oncological-and early continence-rates.(c) 2022 AEU. Published by Elsevier Espan similar to a, S.L.U. All rights reserved.

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