title: Minimum 5-year follow-up of 1138 consecutive laparoscopic radical prostatectomies.
abstract: OBJECTIVE
  To investigate the long-term outcomes of laparoscopic radical prostatectomy (LRP).
  
  
  METHODS
  In all, 1138 patients underwent LRP during a 163-month period from 2000 to 2008, of which 51.5%, 30.3% and 18.2% were categorised into D'Amico risk groups of low-, intermediate- and high-risk, respectively. All intermediate- and high-risk patients were staged by preoperative magnetic resonance imaging or computed tomography and isotope bone scanning, and had a pelvic lymph node dissection (PLND), which was extended after April 2008. The median (range) patient age was 62 (40-78) years; body mass index was 26 (19-44) kg/m(2) ; prostate-specific antigen level was 7.0 (1-50) ng/mL and Gleason score was 6 (6-10). Neurovascular bundle was preservation carried out in 55.3% (bilateral 45.5%; unilateral 9.8%) of patients.
  
  
  RESULTS
  The median (range) gland weight was 52 (14-214) g. The median (range) operating time was 177 (78-600) min and PLND was performed in 299 patients (26.3%), of which 54 (18.0%) were extended. The median (range) blood loss was 200 (10-1300) mL, postoperative hospital stay was 3 (2-14) nights and catheterisation time was 14 (1-35) days. The complication rate was 5.2%. The median (range) LN count was 12 (4-26), LN positivity was 0.8% and the median (range) LN involvement was 2 (1-2). There was margin positivity in 13.9% of patients and up-grading in 29.3% and down-grading in 5.3%. While 11.4% of patients had up-staging from T1/2 to T3 and 37.1% had down-staging from T3 to T2. One case (0.09%) was converted to open surgery and six patients were transfused (0.5%). At a mean (range) follow-up of 88.6 (60-120) months, 85.4% of patients were free of biochemical recurrence, 93.8% were continent and 76.6% of previously potent non-diabetic men aged <70 years were potent after bilateral nerve preservation.
  
  
  CONCLUSIONS
  The long-term results obtainable from LRP match or exceed those previously published in large contemporary open and robot-assisted surgical series.
authors.affiliation: Department of Urology, Royal Surrey County Hospital, Guildford, Surrey, UK.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Soares
authors.forename: Antonina
authors.initials: A
authors.lastname: Di Benedetto
authors.forename: Zach
authors.initials: Z
authors.lastname: Dovey
authors.forename: Simon
authors.initials: S
authors.lastname: Bott
authors.forename: Roy G
authors.initials: RG
authors.lastname: McGregor
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Eden
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: laparoscopy; outcomes; prostate cancer; radical prostatectomy