Laparoscopic radical prostatectomy: Oncological outcome analysis from a single-center Indian experience of 6 years

• Main Authors: Shashikant Mishra, Vikas Agrawal, Naushad Khatri, Rajan Sharma, Abraham Kurien, Arvind Ganpule, V Muthu, Ravindra B Sabnis, Mahesh R Desai
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2012-01-01
• Series: Indian Journal of Urology
• Subjects: Biochemical recurrence; Indian experience; laparoscopic radical prostatectomy; oncological outcome
• Online Access: http://www.indianjurol.com/article.asp?issn=0970-1591;year=2012;volume=28;issue=1;spage=32;epage=36;aulast=Mishra
• ISSN: 0970-1591; 1998-3824

Background: There is a lack of published data on laparoscopic radical prostatectomy (LRP) in India. Although the published short-term oncologic outcomes after LRP are encouraging, intermediate and long-term data are lacking. Objective: We analyzed the oncological outcome after LRP based on 6 years of experience and compared it with the other single-center published literature. Materials and Methods: Of the 90 patients who underwent LRP for a clinical T2 localized disease, 73 patients with at least a follow up of one year were analyzed. Patients were classified as low-, intermediate-, and high-risk D′Amico groups in 22 (30%), 26 (36%), and 25 (34%) of the patient population, respectively. Progression of disease was defined as a PSA of 0.4ng/ml with a confirmatory rise. We used Kaplan-Meier product limit estimates to calculate actuarial 5-year probabilities of biochemical progression-free survival. Univariate analysis of risk factors for biochemical recurrence (BCR) was done. Results: The mean age of the patients was 63.3 ± 6.6 years. The average follow-up for patients was 22 (12-72) months. There was no prostatic cancer-specific mortality. Fourteen patients had BCR. The 5-year progression-free probability for men with low-, intermediate-, and high-risk prostate cancers was 91%, 82%, and 58%, respectively. High-risk group, Gleason sum more than 8, extracapsular extension, and positive surgical margin were significantly associated with biochemical progression. Conclusions: LRP provided a similar level of oncological success as reported by the other contemporary single-center published literature