title: Laparoscopic Radical Prostatectomy Plus Extended Lymph Node Dissection in Combination With Immediate Androgen Deprivation Therapy for Cases of pT3-4N0-1M0 Prostate Cancer: A Multimodal Study of 8 Years' Follow-up.
abstract: To investigate the functional and oncologic outcomes of patients with locally advanced or lymph node (LN) metastatic prostate cancer (PCa) treated by laparoscopic radical prostatectomy (LRP) with extended lymph node dissection (ePLND).
  
  
  
  From June 2004 to March 2014, a total of 232 cases (pT3-4N0-1M0) including 160 locally advanced PCa and 72 LN metastatic PCa who received immediate androgen deprivation therapy after LRP plus ePLND were enrolled onto our study. The patients were followed up for 12 to 124 months. Surgical records, surgical margin status, complications, urinary continence, and oncologic outcomes were presented.
  
  
  
  The mean operation time and bleeding were 230 minutes and 105 mL, respectively. The rates of urinary continence were 91.4% and 94.8% at 6 and 12 months, respectively. We observed 122 biochemical recurrent cases. The 5- and 8-year biochemical relapse-free survival rates were 47.3% and 46.7%, respectively. The 5- and 8-year overall and cancer-specific survivals were 81.2%, 80.1%, 90.6%, and 90.6%, respectively. The survival analysis showed that biochemical recurrence-free survival rates were significantly lower for patients with higher Gleason score (77.3% vs. 39.6% vs. 30.8%, P = .003 log rank), higher T stage (55.7% vs. 41.4% vs. 21.4%, P = .039 log rank), positive surgical margin (51.1% vs. 29.3%, P = .000 log rank), and higher CAPRA-S score (68.6% vs. 35.0% vs. 29.2%, P = .000 log rank). There were no significant differences in biochemical relapse-free (40.9% vs. 49.3%, P = .286), overall (75.6% vs. 81.9%, P = .398), and cancer-specific (87.3% vs. 92.1%, P = .284) survival between LN-positive and -negative PCa.
  
  
  
  LRP plus ePLND in combination with immediate androgen deprivation therapy is a feasible approach to patients with pT3-4N0-1M0 PCa; favorable functional and oncologic outcomes were presented postoperatively.
authors.affiliation: Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Department of Urology, Foshan First Municipal People's Hospital, Foshan, China.
authors.forename: Guo-Liang
authors.initials: GL
authors.lastname: Hou
authors.affiliation: Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Qun-Xiong
authors.initials: QX
authors.lastname: Huang
authors.affiliation: Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Pang
authors.affiliation: Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. Electronic address: urologygx@126.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Gao
mesh_terms: D000726:Androgen Antagonists / Q000008:administration & dosage* / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D000072662:Margins of Excision; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D061646:Operative Time; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists
keywords: Biochemical recurrence; Extended lymph node dissection; Laparoscopic radical prostatectomy; Locally advanced prostate cancer; Survival