Abstract
Prostate cancer is the most commonly diagnosed solid tumor cancer in both Europe and the US. Although there were previously low incidence and mortality rates of prostate cancer in Taiwan, these rates have risen rapidly in the past two decades. Options for minimally invasive surgical treatment of localized prostate cancer include laparoscopic radical prostatectomy (LRP), and robotic-assisted laparoscopic radical prostatectomy (RALP). Trends in treatment for localized prostate cancer after emergence of robotic-assisted laparoscopic radical prostatectomy were obvious. The percentage of RALP in patients with localized prostate cancer receiving radical prostatectomy is now about 70% in this institute. There is potential of robotic-assisted prostatectomy to become the mainstream treatment for localized prostate cancer in Taiwan. Twelve-month continence rates ranged from 66% to 95% after LRP. In terms of erectile function recovery, the 12- and 18-mo potency rates reported in noncomparative studies ranged from 42% to 76% after LRP. Better functional results were suggested following RALP. Excellent functional outcomes were reported in several large series from referral centers with high volume of RALP, showing continence rates ranging from 84% to 97% and potency rates from 70% to 80%. The positive surgical margin (PSM) rate was from 11% to 30% after LRP, and from 9.6% to 26% after RALP. Experience with 270 cases of RALP performed by single surgeon showed excellent continence rate and acceptable potency rate. There is still much room to improve cancer control by reducing the positive surgical margin rate.
Published Version
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