title: Long-term oncological and functional results of extraperitoneal laparoscopic radical prostatectomy: one surgical team's experience on 1,600 consecutive cases.
abstract: OBJECTIVE
  To determine the oncologic and functional outcomes of ELRP on a single surgical team's series.
  
  
  METHODS
  A total of 1,600 consecutive ELRP patients were recorded with a 2-year follow-up. In 778 patients, a 5-year follow-up was available.
  
  
  RESULTS
  The mean operative time was 125,6 min (PLND not included) and 150,9 min (PLND included). Postoperative stage was pT2a in 282 patients (17.6 %), pT2b in 877 (54.8 %), pT2c in 18 (1.1 %), pT3a in 241 (15 %), and pT3b in 182 (11.3 %). Positive margins were detected in 7.4 and 13.4 % of pT2 and pT3 tumors, respectively. Overall complication rate was 4 %. PSA levels resulted in <0.2 ng/mL in 96.4, 94.9, 92, 90.9, and 81.5 % of the cases at 3, 12, 24, 36, and 60 months after surgery, respectively. BCRFS rates 5 years after ELRP were 88.7 % for patients staged as pT2, 73.9 % for pT3a, and 62.4 % for pT3b. Complete urinary continence rate resulted in 39 and 92 % after 1 and 12 months, respectively, with a further increase from 92 to 98.4 % at 24-month follow-up. A nerve-sparing procedure was performed in 45 % of patients. The overall potency rate at 12-month follow-up was 38.67 % for UNSS patients and 75 % for BNSS patients. Potency recovery was age-dependent, with patients aged <55 years who resulted potent in 46.8 % of UNSS and 95.8 % of BNSS after 24 months.
  
  
  CONCLUSIONS
  ELRP is a standardized and safe procedure that implies advantages of both minimally invasive and extraperitoneal approaches with elevated standards for oncologic and functional outcomes obtained at long-term follow-up.
authors.affiliation: Department of Urology, University of Naples Federico II, Naples, Italy. p.verze@gmail.com
authors.forename: Paolo
authors.initials: P
authors.lastname: Verze
authors.forename: Salvatore
authors.initials: S
authors.lastname: Scuzzarella
authors.forename: Giorgio R
authors.initials: GR
authors.lastname: Martina
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Giummelli
authors.forename: Federico
authors.initials: F
authors.lastname: Cantoni
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mirone
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000503:physiopathology