Comparing the efficacy of laparoscopic and open radical prostatectomy: analysis of treatment outcomes in patients with prostate cancer treated in three federal centers

K M Nyushko,B Ya Alekseev,A A Krasheninnikov,S A Ivanov,V P Perepukhov,E O Shchukina,V S Chaykov,I M Shevchuk,P S Kozlova,O B Karyakin,A D Kaprin,I O Dementyev

doi:10.17650/1726-9776-2021-17-1-45-53

K M Nyushko, B Ya Alekseev + Show 10 more

Open Access

https://doi.org/10.17650/1726-9776-2021-17-1-45-53

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Journal: Oncourology	Publication Date: May 6, 2021
Citations: 2	License type: cc-by

Affiliation: Moscow State University of Food Production

Abstract

Background. Prostate cancer is currently one of the most challenging problems in urological oncology due to its constantly increasing incidence and mortality in Russia. Surgery remains one of the most radical treatment options for patients with localized and locally advanced prostate cancer of any risk. Multiple studies have compared long-term and functional outcomes of surgeries performed using different surgical approaches. All studies have demonstrated similar long-term and functional outcomes of open, laparoscopic, and robot-assisted surgeries. Objective: to review the existing literature on this problem and analyze outcomes of surgical treatment in patients who had undergone open or laparoscopic prostatectomy in one of three federal centers of the National Medical Research Radiology Center.Materials and methods. This retrospective study included 2,772 patients with localized and locally advanced prostate cancer who had undergone surgery in one of the three federal centers.Results. We evaluated short-term and long-term outcomes of laparoscopic and open radical retropubic prostatectomy (RRP) performed at three federal centers of the National Medical Research Radiology Center. We found that laparoscopic RRP was associated with a longer surgery, lower blood loss, and fewer lymph nodes removed compared to open RRP. Long-term oncological and functional outcomes (prostate-specific antigen relapse-free survival, time to urination recovery) did not significantly differ between patients who had laparoscopic or open RRP.Conclusion. Both open and laparoscopic RRP are equally effective surgical methods for patients with localized and locally advanced prostate cancer.

Highlights

Prostate cancer is currently one of the most challenging problems in urological oncology due to its constantly increasing incidence and mortality in Russia
We evaluated short-term and long-term outcomes of laparoscopic and open radical retropubic prostatectomy (RRP) performed at three federal centers of the National Medical Research Radiology Center
We found that laparoscopic RRP was associated with a longer surgery, lower blood loss, and fewer lymph nodes removed compared to open RRP

Summary

Background

Наличие ПХК, частота серьезных осложнений, время операции и потребность в переливании крови были сопоставимы между ЛРПЭ и РАРПЭ [11]. На основании количества используемых прокладок в день после операции удержание мочи было достигнуто у 83,2 и 82,8 % пациентов групп ОРПЭ и ЛРПЭ соответственно (р = 0,872). Явилось сравнение результатов РАРПЭ / ЛРПЭ с таковыми после ОРПЭ у больных локализованным РПЖ. По их результатам не наблюдалось значимых различий между РАРПЭ / ЛРПЭ и ОРПЭ по общей частоте осложнений, наличию ПХК, а также выявлению биохимического рецидива. Несмотря на тот факт, что, по данным ряда некоторых исследований, РАРПЭ и ЛРПЭ демонстрируют лучшие, чем ОРПЭ, функциональные результаты и несколько меньшее количество осложнений, отдаленные онкологические результаты операции при применении данных 3 методов доступа являются сопоставимыми.

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Findings

Oncology Research Institute