RESULTS RADICAL PROSTATECTOMY AT CHO RAY HOSPITAL

Abstract

Objective: Radical prostatectomy is the standard surgical treatment for clinically localized prostate cancer. We report the results of radical prostatectomy at Cho Ray hospital after 10 years.

Methods: All cases of prostate cancer underwent radical prostatectomy from January 2011 to December 2020 at Urology Department, Cho Ray hospital. Data elements included patient age, body mass index (BMI), prostate volume, prostate specific antigen (PSA) level, TNM stage, preoperative and postoperative Gleason score. Surgical outcomes consisted of operative time, estimated blood loss, complications, postoperative time, catheterization time, oncological results, continence rate, biochemistry recurrence rate, overall survival and progression-free survival rate after 5 years.

Results: Total of 89 patients with stage T1b to T3b prostatic cancer and Gleason score 6-10 underwent radical prostatectomy. Mean age 66.43 ± 6.57 (53-82) years, mean BMI 22.9 ± 2.8 (16-32). Mean prostate volume 40.1 ± 29.38 (8-252) mL, preoperative PSA level 32.8 ± 29.6 (1-143) mg/dL. Mean operating time was 396.7 ± 98.2 (140-660) minutes and estimated blood loss of 433.7 ± 469.5 (50-3000) mL. There were 17 case in open surgery group, 27 case in laproscopic surgery group and 45 case in robot surgery group. Pelvic lymph node dissection was performed in 78 patients (87.6%). Complication rate was 7.9%, all of complications belonged to Clavien class 0-I. Pathology stage: 53 cases T2 (59.5%), 33 cases T3 (37.1%), 3 case T4 (3.4%) and 10 cases had positive lympho nodes (11.2%). Nineteen cases (23.8%) had positive surgical margin. There was 69.9% (51/89 case) PSA ≤0.1 ng/ml after 8 weeks. Biochemical recurrence (BCR) rate was 39.2% with mean BCR time 15.1 ± 19.8 (3-84) months. Continence rate was 81.5% (53/65 cases). The 5-year overall survival rate and progression free survival was 82.4% and 70.2%, respectively.

Conclusions: Radical prostatectomy is safe and efficient procedure with promising results regarding not only functional outcomes but also oncologic outcomes.

Keywords: radical prostatectomy, prostate cancer, overall survival