Oncological and functional results of antegrade radical retropubic prostatectomy for the treatment of clinically localised prostate cancer.
OBJECTIVE
To present the oncological outcome of the antegrade radical prostatectomy in the whole series of consecutive patients treated over an 18-yr period, and to report the functional results and complications of the last 488 patients.


METHODS
We reviewed the clinicopathological data of 845 patients treated between 1988 and 2005. Complete data on continence, potency, and complication were available on the last 488 patients treated between 2000 and 2005.


RESULTS
Positive surgical margins were detected in 12.8% of patients. The mean follow-up was 49 mo. The 8-yr biochemical recurrence-free survival rates were 84.1% for pT2, 69.9% for pT3a, and 37.3% for pT3b disease (p<0.0001). The multivariate analysis showed stage, PSA, and Gleason score as significant independent predictors of biochemical recurrence-free survival. After 12 mo, 94.1% of patients were continent, and 69.6% of patients who had bilateral nerve-sparing prostatectomy were potent. Mean estimated blood loss was 223 cc; overall incidence of complication was lower than 15%.


CONCLUSIONS
Antegrade radical prostatectomy provides a low incidence of positive margins and an optimal cancer control. This technique can provide a low incidence of complications, reduced blood loss, and optimal functional results in terms of recovery of continence owing to a complete definition of the anatomical boundaries of the apex. Moreover, it can provide a less challenging nerve-sparing procedure with similar results to those reported by the retrograde approach.
Carini
Marco
M
Department of Urology, University of Florence, Careggi Hospital, Florence, Italy. carini@unifi.it
Masieri
Lorenzo
L
Minervini
Andrea
A
Lapini
Alberto
A
Serni
Sergio
S
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D018572:Disease-Free Survival; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000453:epidemiology / Q000473:pathology; D009367:Neoplasm Staging; D010410:Penile Erection; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D014563:Urodynamics
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen