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[Changing indications and histological and biological results of radical prostatectomy]
B Malavaud1, C Mazerolles, P Rischmann
1Service d'Urologie, Hôpital Purpan, Toulouse, France.
Objectives:
To compare: 1) the incidence of positive resection margins after radical prostatectomy, 2) the incidence of secondary elevation of PSA, in two groups of patients operated before and after May 1994.
Methods:
We collected and compared preoperative (PSA, Gleason score on biopsies, positive apical biopsies) and postoperative variables (number and site of positive margins, secondary elevation of PSA) in two historical cohorts of 115 and 67 patients undergoing retropubic radical prostatectomy.
Results:
We currently operate on tumours characterized by lower PSA values with a smaller proportion of positive apical biopsies. Inversely, the proportion of high Gleason scores appears to be greater, although the difference is not statistically significant. The decreased incidence of positive resection margins and PSA failure rate compared to our initial series reflects the improvement of the oncological results. The respective place of improvement of techniques and changing indications has yet to be defined.
Conclusion:
This study demonstrates the changing operative indications and histological and laboratory results over time. The documented improvement of oncological results is partly related to the progress in surgical indications.