title: Laparoscopic radical prostatectomy with the Heilbronn technique: oncological results in the first 500 patients.
abstract: OBJECTIVE
  Laparoscopic radical prostatectomy has become an accepted alternative to open surgery. However, there is still a lack of data concerning the oncological outcome.
  
  
  METHODS
  From March 1999 to July 2004, 1,078 patients underwent laparoscopic radical prostatectomy at our institution. Oncological results in the first 500 patients with a minimal followup of 23 months were analyzed, focusing on positive margins, prostate specific antigen (PSA) failure, clinical progression and survival.
  
  
  RESULTS
  Median followup was 40 months (range 23 to 65). Of the patients 417 underwent pelvic lymph node dissection, which revealed positive nodes in 6 (1.2%). Positive margins were documented in 22 of 296 pT2 tumors (7.4%), 27 of 107 pT3a tumors (25.2%) and 29 of 69 pT3b tumors (42.0%). PSA recurrence was diagnosed in 55 patients (11.0%) at a mean of 20.8 months (range 6 to 36) that is stages pT2a, pT2b, pT3a and pT3b/4 in 3.2%, 6.5%, 15.9% and 23.9%, respectively. PSA progression-free rates were 83.0% at 3 years and 73.1% at 5 years. Two patients died of disease and 6 died of other causes (99.2% overall survival). The clinical progression rate was to 4.1% at 3 years and 9.8% at 5 years. No port site metastasis was observed.
  
  
  CONCLUSIONS
  At centers of expertise laparoscopic radical prostatectomy may provide an oncological outcome similar to that of the open procedure. However, it offers the advantages of minimally invasive surgery.
authors.affiliation: Department of Pathology, Klinikum Heilbronn, University of Heidelberg, Heidelberg, Germany. jens.rassweiler@slk-kliniken.de
authors.forename: Jens
authors.initials: J
authors.lastname: Rassweiler
authors.forename: Michael
authors.initials: M
authors.lastname: Schulze
authors.forename: Dogu
authors.initials: D
authors.lastname: Teber
authors.forename: Reinaldo
authors.initials: R
authors.lastname: Marrero
authors.forename: Othmar
authors.initials: O
authors.lastname: Seemann
authors.forename: Joachim
authors.initials: J
authors.lastname: Rumpelt
authors.forename: Thomas
authors.initials: T
authors.lastname: Frede
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate