[Laparoscopic radical prostatectomy in the elderly (>75 years old): oncological and functional results].
OBJECTIVE
Prostate cancer incidence increases with age. Radical prostatectomy (RP) seems to be feasible for elderly well-selected patients. We report our experience with patients older than 75 years old who underwent laparoscopic RP.


METHODS
From 2000 to 2007, 22 patients older than 75 years old at time of surgery were included in the study. The patient clinical characteristics, the peri- and postoperative data, and the pathological data were collected retrospectively. The overall, specific and PSA-free survival were analysed with Kaplan-Meier method. The functional results such as continence and erectile function were assessed by self-questionnaires.


RESULTS
The mean patient age was 75 years (75-81), the median PSA level was 10.77 ng/ml (5-30). The mean American Society of Anesthesiologists score was 2.1 (2-3). Two (9%) perioperative complications occurred but no conversion was necessary. Five patients (23%) had a pT3 disease and the overall positive surgical margins rate was 14%. With a median follow-up of 42 months, no patient has died and five had a biochemical recurrence. At 12-month follow-up, 82% of patients were continent (no pad) and potency (erection sufficient for intercourse) rate was 36% with or without the use of phosphodiesterase-5 inhibitors.


CONCLUSIONS
Laparoscopic RP is feasible for localized prostate cancer in elderly well-selected patients with satisfactory oncological and functional outcomes although the incontinence rate is increased comparing to younger patients.
Service d'urologie, hôpital Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France. evanguelosxylinas@hotmail.com
E
E
Xylinas
G
G
Ploussard
A
A
Paul
N
N
Gillion
D
D
Vordos
A
A
Hoznek
A
A
De La Taille
C-C
CC
Abbou
L
L
Salomon
D000368:Aged; D000369:Aged, 80 and over; D007172:Erectile Dysfunction / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
D017430:Prostate-Specific Antigen