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Oncologic Outcome of Laparoscopic and Open Radical Prostatectomy
Gregory J Wirth, Sarah P. Psutka, Shulin Wu, Chin-Lee Wu, Douglas M. Dahl
Massachusetts General Hospital, Boston, MA

Introduction: The aim of this study is to assess the rate of biochemical recurrence following open (RRP) and laparoscopic radical prostatectomy (LRP). Contrary to sequential series, we provide outcomes of patients operated during the same time span.
Materials & Methods: A single center, retrospective analysis of 777 patients operated between 2002 and 2006 for localized prostate cancer.
Results: Two hundred and five cases of RRP were compared to 572 cases of LRP. Both groups were comparable for age (58.3 (RRP) vs. 58.2 (LRP) years), Gleason score (93% vs. 92% Gleason score 7 or less), stage (82% vs. 82% pT2), pre-operative PSA (6.0 vs. 5.9 ng/ml) and margin status (18 vs. 19% positive margins). Mean time to biochemical recurrence (BCR) was 2.8 years, mean follow-up of patients in remission 3.6 years. Univariable analysis showed identical cumulative BCR rates in both groups. In a multivariable Cox regression model, surgical technique showed no significant impact on recurrence (HR=0.95, p=0.82), whereas Gleason score, stage, PSA, margin status and BMI were significant prognostic factors. Predictive accuracy of the model was 82%.
Conclusions:
In this series of patients with similar clinicopathologic features and operated in a single center during the same time period, the surgical approach had no impact on postoperative biochemical recurrence.


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