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Related Experiment Videos

Surgical therapy for localized prostatic carcinoma

J Noldus1, P Hammerer, M Graefen

  • 1Department of Urology, University of Hamburg, Germany.

Journal of Cancer Research and Clinical Oncology
|January 1, 1997
PubMed
Summary

Anatomical radical retropubic prostatectomy is a safe and effective treatment for localized prostate cancer, achieving high continence rates and significant prostate-specific antigen (PSA) negativity. This procedure can cure approximately 70% of patients with clinical T1b-T2 tumors.

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Area of Science:

  • Urology
  • Oncology
  • Surgical Oncology

Background:

  • Radical prostatectomy is a primary treatment for localized prostate cancer.
  • Assessing outcomes, including morbidity and prostate-specific antigen (PSA) levels, is crucial for evaluating surgical techniques.
  • Anatomical radical retropubic prostatectomy has been utilized for clinical T1b, T1c, and T2 tumors.

Purpose of the Study:

  • To evaluate the intraoperative, immediate postoperative, and late postoperative morbidity associated with anatomical radical retropubic prostatectomy.
  • To assess prostate-specific antigen (PSA) nadir levels following the procedure.
  • To determine the oncological outcomes and safety profile in a cohort of 511 patients.

Main Methods:

  • Retrospective analysis of 511 consecutive patients undergoing anatomical radical retropubic prostatectomy between 1988 and 1995.

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  • Specimens processed using step-section technique with inked margins for status identification.
  • Data collection on intraoperative complications, postoperative morbidity, continence, anastomotic stricture, and PSA levels.

    • Main Results:

    • Mean patient age was 63.4 years; blood loss decreased over time.
    • Morbidity included rectal perforation (4.3%), ureteral injury (1.4%), prolonged lymphocele (11%), DVT (3.7%), and pulmonary embolism (1%, with 0.6% mortality).
    • Postoperative outcomes: 92% continence at 1 year, 5.8% anastomotic stricture, 80% undetectable PSA at 12 months, with PSA negativity correlating to tumor stage.

    Conclusions:

    • Anatomical radical retropubic prostatectomy is a safe procedure for clinical T1b-T2 prostate cancer.
    • The study demonstrates significant rates of urinary continence and biochemical cure (PSA negativity).
    • Approximately 70% of patients with localized prostate cancer can be cured with this surgical approach.