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CC BY 4.0 · Surg J (N Y) 2018; 04(04): e226-e234
DOI: 10.1055/s-0038-1675827
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Oncological Outcomes of Open Radical Retropubic Prostatectomy in Ireland: A Single Surgeon's 5-Year Experience

Stefanie M. Croghan
1   Department of Urology, The Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland
,
Deep Mudit Matanhelia
2   Department of Urology, St. Vincent's University Hospital, Elm Park, Dublin, Ireland
,
Ann T. Foran
1   Department of Urology, The Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland
,
David J. Galvin
1   Department of Urology, The Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland
2   Department of Urology, St. Vincent's University Hospital, Elm Park, Dublin, Ireland
3   Department of Urology, St. Vincent's Private Hospital, Elm Park, Dublin, Ireland
› Author Affiliations
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Publication History

29 July 2018

08 October 2018

Publication Date:
28 November 2018 (online)

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Abstract

Objectives There is a little published data on the outcomes of radical prostatectomy in the Irish context. We aimed to determine the 5-year oncological results of open radical retropubic prostatectomy (RRP) performed by a single surgeon following appointment.

Methods A retrospective review of RRPs performed between 2011 and 2016 was conducted. Patient demographics, preoperative parameters (clinical stage on digital rectal exam, prostate-specific antigen (PSA) levels, biopsy Gleason's score and MRI [magnetic resonance imaging] findings), pathological variables (T-stage, Gleason's score, nodal status, and surgical margin status), and treatment decisions (lymphadenectomy or adjuvant radiotherapy) were recorded. Oncological outcome at last follow-up was ascertained.

Results 265 patients underwent RRP between 2011 and 2016. Median age was 62 years (range: 41–74). Mean follow-up was 32.24 months (range: 8–72) months. Pathological disease stage was T2 in 170/265 (64.15%), T3a in 65/265 (24.53%), and T3b in 30/265 (11.32%). Final Gleason's score was upgraded from diagnostic biopsy in 16.35% (43/263) and downgraded in 27% (71/263). Pelvic lymph node dissection was performed in 44.25% (118/265) patients. A positive surgical margin (PSM) was seen in 26/170 (15.2%) patients with T2 disease and in 45/95 (47.37%) patients with T3 disease. Of the 265 patients, 238 (89.81%) were disease-free at last follow-up, of whom 24/238 (10.08%) had received adjuvant and 17/238 (7.14%) received salvage radiotherapy. Adjuvant/salvage treatment was ongoing in 19/265 (7.17%) of patients.

Conclusion Good oncological outcomes of RRP in the Irish context are seen in this 5-year review, with the vast majority of patients experiencing biochemical-free survival at most recent follow-up.

Keywords

radical retropubic prostatectomy - RRP - open prostatectomy - prostate cancer - oncological outcomes

Financial Support

None


 

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