Korean J Urol Oncol.  2016 Dec;14(3):144-151. 10.22465/kjuo.2016.14.3.144.

Twenty-Year Single Surgeon Experience with Radical Perineal Prostatectomy: Oncologic, Functional Outcomes and Perioperative Complications

• Park JH
• Lee SE
• Choi YH
• Song W
• Choi HY

• KMID: 2368948
• DOI: http://doi.org/10.22465/kjuo.2016.14.3.144

Abstract

PURPOSE
To evaluate oncologic, functional outcomes and complications in patients with prostate cancer (PCa) who underwent radical perineal prostatectomy (RPP).
MATERIALS AND METHODS
A retrospective review of patients who underwent RPP by a single surgeon between 1995 and 2014 was performed. We analyze clinicopathologic characteristics and postoperative complications including urinary continence and erectile function. Kaplan-Meier survival analysis was used to access biochemical recurrence (BCR)-free survival (BFS) and cancer-specific survival (CSS) and log-rank test was applied. Complications were stratified by the Clavien-Dindo classification system.
RESULTS
A total of 816 patients were included in this study. The mean prostate-specific antigen and prostate volume was 8.89 ng/mL and 30.8 mL. Positive surgical margin was identified in 174 patients (21.3%) after RPP. During a mean follow-up of 58.7 months, 173 patients (21.2%) experienced BCR. Overall, 44 patients (5.4%) died, of which 15 (1.8%) died from PCa. The 5-year BFS in patients with T2, T3a, and T3b were 84.8%, 69.7%, and 46.7% (p<0.001), respectively. The 10-year CSS in patients with same groups were 98.9%, 98.2%, and 79.5% (p<0.001), respectively. At 12 months after RPP, recovery of urinary continence and erectile function was identified in 88.3% and 63.7% of patients. Wound dehiscence (8.9%) was the most common complication. However, approximately 78% of complications were grade I or II.
CONCLUSIONS
Our study indicates that RPP shows acceptable outcomes in terms of oncologic results and complications in patients with PCa. Careful attention is required to prevent wound dehiscence.

Keyword

Prostatic neoplasms; Oncologic outcomes; Complications; Radical perineal prostatectomy

MeSH Terms

Classification
Follow-Up Studies
Humans
Passive Cutaneous Anaphylaxis
Postoperative Complications
Prostate
Prostate-Specific Antigen
Prostatectomy*
Prostatic Neoplasms
Recurrence
Retrospective Studies
Wounds and Injuries
Prostate-Specific Antigen