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Yang Y, Luo Y, Hou GL, Huang QX, Pang J, Gao X. Laparoscopic Radical Prostatectomy Plus Extended Lymph Node Dissection in Combination With Immediate Androgen Deprivation Therapy for Cases of pT3-4N0-1M0 Prostate Cancer: A Multimodal Study of 8 Years' Follow-up. Clin Genitourin Cancer 2016; 14:e321-7. [DOI: 10.1016/j.clgc.2015.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 10/22/2015] [Accepted: 11/11/2015] [Indexed: 11/27/2022]
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Abstract
Prostate cancer is the most common noncutaneous cancer affecting men today. It largely affects men in the fifth and sixth decade of life. Screening for prostate cancer, though controversial, is still the only way to detect early prostate cancer. Multiple newer options such as blood tests and genetic markers are being used in the clinical domain today to improve cancer detection and avoid unnecessary biopsies. To date, biopsy of the prostate remains the only modality to stratify the grade of cancer. Significant improvements in the imaging technology have improved localizing and detecting the disease. Treatment of prostate cancer is stratified on the basis of the grade and volume of the disease. There are multiple treatment options involved in the management of prostate cancer. Treatment of localized prostate cancer still continues to have very high cure rates and long-term cancer-specific survival rates.
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Affiliation(s)
- Nilesh Patil
- Division of Urology, University of Cincinnati, Cincinnati, Ohio
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Laparoscopic radical prostatectomy plus extended lymph nodes dissection for cases with non-extra node metastatic prostate cancer: 5-year experience in a single Chinese institution. J Cancer Res Clin Oncol 2013; 139:871-8. [PMID: 23417085 DOI: 10.1007/s00432-013-1395-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 02/05/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To investigate the functional and oncologic outcomes of patients with locally advanced or lymph node metastatic prostate cancer (PCa) treated by laparoscopic radical prostatectomy (LRP) in a single Chinese institution. METHODS From June 2004 to June 2011, a total of 152 cases including 105 locally advanced PCa and 47 lymph node metastatic PCa who were treated by LRP with extended lymph node dissection (ePLND) were enrolled in this study. Surgical records, urinary continence, complications, and oncologic outcomes were presented. RESULTS The mean operation time and bleeding were 240 min and 110 ml, respectively. After 12-87 months (median 48 m) of follow-up, 91.4 and 94.7 % of the patients were urinary continence at 6 and 12 m, respectively. Eighty biochemical recurrent diseases were observed. The 3- and 5-year biochemical progression-free survival rates were 59.2 and 47.3 %, respectively. Multivariate analysis showed that Gleason score (HR: 1.66, 95 % CI: 1.05-2.64, P = 0.031), pathological stage (HR: 1.64, 95 % CI: 1.2-2.23, P = 0.002), and surgical margin status (HR: 1.75, 95 % CI: 1.04-2.95, P = 0.035) were independent predictive factors for subsequent biochemical relapse. The 3- and 5-year overall and cancer-specific survival rates were 90.2, 86.0 and 95.8, 92.3 %, respectively. There were no significant differences in biochemical recurrence-free (42.6 vs. 49.5 %, P = 0.491), overall (83.4 vs. 87.3 % P = 0.503), and cancer-specific survival rates (92.3 vs. 94.9 %, P = 0.801) between lymph node-positive and -negative PCa. CONCLUSION With favorable functional and oncologic outcomes in this cohort of 152 patients, we concluded that LRP plus ePLND is feasible for patients with locally advanced non-extra node metastatic PCa.
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Van Poppel H, Joniau S, Haustermans K. Surgery alone for advanced prostate cancer? EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70036-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Larré S, Salomon L, Abbou CC. Choices for Surgery. Prostate Cancer 2007; 175:163-78. [PMID: 17432559 DOI: 10.1007/978-3-540-40901-4_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Surgical treatment of prostate cancer has seen many improvements in the past two decades, including laparoscopy, robotic surgery, and better assessment of quality of life and functional results. The limits of surgery for locally advanced disease and after failure of radiotherapy have been better defined, together with the roles of neoadjuvant and adjuvant treatment. Patients with clinically organ-confined prostate cancer, reasonable life expectancy, and little or no co-morbidity are the best candidates for radical prostatectomy. This chapter reviews the different technical options for the treatment of prostate cancer, with their respective indications and functional and oncological results.
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Affiliation(s)
- Stéphane Larré
- Department of Urology, University Hospital Henri Mondor, Créteil, France
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Gontero P, Marchioro G, Pisani R, Zaramella S, Sogni F, Kocjancic E, Mondaini N, Bonvini D, Tizzani A, Frea B. Is Radical Prostatectomy Feasible in All Cases of Locally Advanced Non-Bone Metastatic Prostate Cancer? Results of a Single-Institution Study. Eur Urol 2007; 51:922-9; discussion 929-30. [PMID: 17049718 DOI: 10.1016/j.eururo.2006.08.050] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2006] [Accepted: 08/25/2006] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Previous prospective studies of the surgical treatment of locally advanced prostate cancer have enrolled patients selected on the basis of a limited T3 disease extension. The aim of the present study was to assess the feasibility and the oncologic outcome of radical prostatectomy administered to a consecutive unselected series of advanced, non-bone metastatic prostate cancers. METHODS Between March 1998 and February 2003 radical prostatectomy was offered at our institution to any patient diagnosed with prostate cancer with no sign of extranodal metastatic disease. Data on morbidity and survival for 51 clinically advanced cases (any T>/=3, N0-N1, or any N1 or M1a disease according to the TNM 2002 classification system) operated on by a single expert surgeon were compared with a series of 152 radical prostatectomies performed during the same period by the same operator for clinically organ-confined disease. Adjuvant treatment was administered according to current guidelines. RESULTS The two groups did not differ significantly in surgical morbidity except for blood transfusion, operative time, and lymphoceles, which showed a higher rate in patients with advanced disease. The Kaplan-Meier estimate of overall survival and prostate cancer-specific survival at 7 yr were 76.69% and 90.2% in the advanced disease group and 88.4% and 99.3% in the organ-confined disease group, respectively. CONCLUSIONS Even in the scenario of extensive surgical indications up to M1a disease, radical prostatectomy proved to be technically feasible and to have an acceptable morbidity rate compared with organ-confined disease. Our initial survival data strengthen the role for surgery as an essential part in the multimodal approach to treating advanced prostate cancer.
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Affiliation(s)
- Paolo Gontero
- Clinica Urologica I, Università degli Studi di Torino, Torino, Italy.
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Han JH, Chang IH, Yu JH, Han BK, Jeong SJ, Hong SK, Byun SS, Lee SE. Efficacy of Radical Retropubic Prostatectomy as the Primary Treatment for Patients with Clinically Localized Prostate Cancer and a Serum PSA Level ≥0ng/ml. Korean J Urol 2007. [DOI: 10.4111/kju.2007.48.9.945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jun Hyun Han
- Department of Urology, KEPCO Medical Foundation Hanil General Hospital, Seoul, Korea
| | - In Ho Chang
- Department of Urology, KEPCO Medical Foundation Hanil General Hospital, Seoul, Korea
| | - Ji Hyeong Yu
- Department of Urology, Inje University Sanggye Baik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Byoung Kyu Han
- Department of Urology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Seong Jin Jeong
- Department of Urology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sung Kyu Hong
- Department of Urology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Seok-Soo Byun
- Department of Urology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sang Eun Lee
- Department of Urology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Spiess PE, Leibovici D, Pisters LL. Surgery for locally advanced disease. Curr Urol Rep 2006; 7:209-16. [PMID: 16630524 DOI: 10.1007/s11934-006-0023-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Locally advanced prostate cancer is diagnosed in approximately one in four new cases of prostate cancer. The estimated disease-specific mortality rate resulting from monotherapy with either surgery or radiotherapy is a disappointing 75%. A multimodality treatment approach could offer more promising results. In addition, several key factors related to surgical treatment of locally advanced prostate cancer may optimize the oncologic results and minimize patient morbidity. In this report, we summarize some of the anatomic features and technical concepts associated with the surgical management of this disease and review recently published results of the outcomes of surgery and neoadjuvant or adjuvant chemohormonal therapy for locally advanced prostate cancer.
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Affiliation(s)
- Philippe E Spiess
- Department of Urology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1373, Houston, TX 77030, USA
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Affiliation(s)
- Kevin M O'Connor
- Department of Surgery, Mater Misericordiae University Hospital, University College Dublin, Ireland.
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Hsu CY, Joniau S, Van Poppel H. Radical Prostatectomy for Locally Advanced Prostate Cancer: Technical Aspects of Radical Prostatectomy. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/j.euus.2005.03.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Zaramella S, Monesi G, Sala M, Favro M, Marchioro G, Gontero P, Kocjancic E, Ceratti G, Pisani R, Maso G, Frea B. Morbility and Outcomes of Radical Prostatectomy in Patients with Clinically Advanced Prostatic Cancer. Urologia 2004. [DOI: 10.1177/039156030407100316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this study we have reviewed patients with prostate cancer clinically advanced at the diagnosis, and subjected at radical prostatectomy, to evaluate the morbility, mortality, and results of the surgery. We have subjected 38 patients with sure clinically advanced disease to radical prostectomy (PSA average 80 ng/mL). An ureteral injury and no rectal lesion have been observed. The rate of urinary incontinence have not been increased in comparison with the literature data, while more frequently are been developed stenosis of bladder neck (26%). At 2 years the 15% of the patients is disease free survival. Our opinion is that radical prostectomy in patients with locally advanced prostate cancer is feasible and the rate of the complications is acceptable.
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Affiliation(s)
- S. Zaramella
- Clinica Urologica, Facoltà di Medicina e Chirurgia, Università degli Studi del Piemonte Orientale “A. Avogadro”, Azienda Ospedaliera “Maggiore della Carità”, Novara
| | - G. Monesi
- Clinica Urologica, Facoltà di Medicina e Chirurgia, Università degli Studi del Piemonte Orientale “A. Avogadro”, Azienda Ospedaliera “Maggiore della Carità”, Novara
| | - M. Sala
- Clinica Urologica, Facoltà di Medicina e Chirurgia, Università degli Studi del Piemonte Orientale “A. Avogadro”, Azienda Ospedaliera “Maggiore della Carità”, Novara
| | - M. Favro
- Clinica Urologica, Facoltà di Medicina e Chirurgia, Università degli Studi del Piemonte Orientale “A. Avogadro”, Azienda Ospedaliera “Maggiore della Carità”, Novara
| | - G. Marchioro
- Clinica Urologica, Facoltà di Medicina e Chirurgia, Università degli Studi del Piemonte Orientale “A. Avogadro”, Azienda Ospedaliera “Maggiore della Carità”, Novara
| | - P. Gontero
- Clinica Urologica, Facoltà di Medicina e Chirurgia, Università degli Studi del Piemonte Orientale “A. Avogadro”, Azienda Ospedaliera “Maggiore della Carità”, Novara
| | - E. Kocjancic
- Clinica Urologica, Facoltà di Medicina e Chirurgia, Università degli Studi del Piemonte Orientale “A. Avogadro”, Azienda Ospedaliera “Maggiore della Carità”, Novara
| | - G. Ceratti
- Clinica Urologica, Facoltà di Medicina e Chirurgia, Università degli Studi del Piemonte Orientale “A. Avogadro”, Azienda Ospedaliera “Maggiore della Carità”, Novara
| | - R. Pisani
- Clinica Urologica, Facoltà di Medicina e Chirurgia, Università degli Studi del Piemonte Orientale “A. Avogadro”, Azienda Ospedaliera “Maggiore della Carità”, Novara
| | - G. Maso
- Clinica Urologica, Facoltà di Medicina e Chirurgia, Università degli Studi del Piemonte Orientale “A. Avogadro”, Azienda Ospedaliera “Maggiore della Carità”, Novara
| | - B. Frea
- Clinica Urologica, Facoltà di Medicina e Chirurgia, Università degli Studi del Piemonte Orientale “A. Avogadro”, Azienda Ospedaliera “Maggiore della Carità”, Novara
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