prostate-report.org

Surgeons reviewed advances in radical prostatectomy

A team at Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA. have reviewed advances in radical prostatectomy over the past 25 years (since the initial introduction of nerve-sparing surgery).

 Today open radical prostatectomy is a less-invasive procedure with low morbidity providing excellent control of clinically localized prostate cancer. Although open radical prostatectomy now accounts for a minority of radical prostatectomies in the United States, the concepts that have improved oncologic and quality-of-life outcomes are equally applicable to minimally invasive procedures.

The team review notes such improvements as the use of smaller incisions, reduced blood loss, shorter hospital stays, and surgical refinements to improve the recovery of continence and potency.

Conclusions point out that, despite the lack of randomized controlled trials, observational cohort studies demonstrate lower rates of positive surgical margins, high 10-year and 15-year biochemical recurrence-free rates, excellent prostate cancer-specific mortality rates, and improved recovery of urinary incontinence and erectile function after open radical prostatectomy. They also point out that, although open radical prostatectomy now accounts for a minority of radical prostatectomies in the United States, the concepts that have improved oncologic and quality-of-life outcomes are equally applicable to minimally invasive procedures.