Abstract

Objective: The best treatment option for locally advanced prostate cancer (cT3) remains controversial. In the recent years, as a result of increased surgical experience, radical prostatectomy has emerged as a treatment option for these patients. In this study, we present our experience with extraperitoneal laparoscopic radical prostatectomy (LRP) for cT3.

Materials and methods: Between January 2007 and December 2009, LRP was performed in 100 patients in our department. Of these patients, 10 cT3 patients who were followed up at least 18 months were enrolled in the study. All operations were performed by the same surgeon. Patient and procedure related data were retrospectively analyzed. 

Results: The mean age was 62.7±6.0 years. The mean operation time was 262.9±21.0 min (range 210-360 min). The mean hospitalization time and mean catheterization time was 4.6±0.5 days (range 3-11 days) and 12.6±0.7 days (range 11-15 days), respectively. The mean blood loss was 310±110 mL (range 100-800 mL) and perioperative blood transfusion was required in 4 patients (40%). The mean continence recovery time was 41.0±1.5 days (range 30-60 days), however 2 patients remained incontinent at the end of 1 year after the operation. Positive surgical margins were identified in 4 patients.

Conclusion: Our preliminary results show that LRP is surgically feasible for clinically advanced prostate cancer with acceptable complication rates. Positive surgical margins and biochemical recurrence remains an important issue as in open radical prostatectomy for LRP.