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Erschienen in: Journal of Cancer Research and Clinical Oncology 5/2013

01.05.2013 | Original Paper

Laparoscopic radical prostatectomy plus extended lymph nodes dissection for cases with non-extra node metastatic prostate cancer: 5-year experience in a single Chinese institution

verfasst von: Ming-Kun Chen, Yun Luo, Hao Zhang, Jiang-Guang Qiu, Xin-Qiao Wen, Jun Pang, Jie Si-Tu, Qi-Peng Sun, Xin Gao

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 5/2013

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Abstract

Objective

To investigate the functional and oncologic outcomes of patients with locally advanced or lymph node metastatic prostate cancer (PCa) treated by laparoscopic radical prostatectomy (LRP) in a single Chinese institution.

Methods

From June 2004 to June 2011, a total of 152 cases including 105 locally advanced PCa and 47 lymph node metastatic PCa who were treated by LRP with extended lymph node dissection (ePLND) were enrolled in this study. Surgical records, urinary continence, complications, and oncologic outcomes were presented.

Results

The mean operation time and bleeding were 240 min and 110 ml, respectively. After 12–87 months (median 48 m) of follow-up, 91.4 and 94.7 % of the patients were urinary continence at 6 and 12 m, respectively. Eighty biochemical recurrent diseases were observed. The 3- and 5-year biochemical progression-free survival rates were 59.2 and 47.3 %, respectively. Multivariate analysis showed that Gleason score (HR: 1.66, 95 % CI: 1.05–2.64, P = 0.031), pathological stage (HR: 1.64, 95 % CI: 1.2–2.23, P = 0.002), and surgical margin status (HR: 1.75, 95 % CI: 1.04–2.95, P = 0.035) were independent predictive factors for subsequent biochemical relapse. The 3- and 5-year overall and cancer-specific survival rates were 90.2, 86.0 and 95.8, 92.3 %, respectively. There were no significant differences in biochemical recurrence-free (42.6 vs. 49.5 %, P = 0.491), overall (83.4 vs. 87.3 % P = 0.503), and cancer-specific survival rates (92.3 vs. 94.9 %, P = 0.801) between lymph node-positive and -negative PCa.

Conclusion

With favorable functional and oncologic outcomes in this cohort of 152 patients, we concluded that LRP plus ePLND is feasible for patients with locally advanced non-extra node metastatic PCa.
Literatur
Zurück zum Zitat Akakura K, Suzuki H, Ichikawa T, Fujimoto H, Maeda O, Usami M et al (2006) A Randomized trial comparing radical prostatectomy plus endocrine therapy versus external beam radiotherapy plus endocrine therapy for locally advanced prostate cancer: results at median follow-up of 102 months. Jpn J Clin Oncol 36:789–793PubMedCrossRef Akakura K, Suzuki H, Ichikawa T, Fujimoto H, Maeda O, Usami M et al (2006) A Randomized trial comparing radical prostatectomy plus endocrine therapy versus external beam radiotherapy plus endocrine therapy for locally advanced prostate cancer: results at median follow-up of 102 months. Jpn J Clin Oncol 36:789–793PubMedCrossRef
Zurück zum Zitat Aus G, Abbou CC, Bolla M, Heidenreich A, Schmid HP, van Poppel H et al (2005) EAU guidelines on prostate cancer. Eur Urol 48:546–551PubMedCrossRef Aus G, Abbou CC, Bolla M, Heidenreich A, Schmid HP, van Poppel H et al (2005) EAU guidelines on prostate cancer. Eur Urol 48:546–551PubMedCrossRef
Zurück zum Zitat Bolla M, Collette L, Blank L, Warde P, Dubois JB, Mirimanoff RO et al (2002) Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): a phase III randomised trial. Lancet 360:103–106PubMedCrossRef Bolla M, Collette L, Blank L, Warde P, Dubois JB, Mirimanoff RO et al (2002) Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): a phase III randomised trial. Lancet 360:103–106PubMedCrossRef
Zurück zum Zitat Briganti A, Chun FK, Salonia A, Gallina A, Farina E, Da Pozzo LF et al (2006) Validation of a nomogram predicting the probability of lymph node invasion based on the extent of pelvic lymphadenectomy in patients with clinically localized prostate cancer. BJU Int 98:788–793PubMedCrossRef Briganti A, Chun FK, Salonia A, Gallina A, Farina E, Da Pozzo LF et al (2006) Validation of a nomogram predicting the probability of lymph node invasion based on the extent of pelvic lymphadenectomy in patients with clinically localized prostate cancer. BJU Int 98:788–793PubMedCrossRef
Zurück zum Zitat Casey JT, Meeks JJ, Greco KA, Wu SD, Nadler RB (2009) Outcomes of locally advanced (T3 or Greater) prostate cancer in men undergoing robot-assisted laparoscopic prostatectomy. J Endourol 23:1519–1522PubMedCrossRef Casey JT, Meeks JJ, Greco KA, Wu SD, Nadler RB (2009) Outcomes of locally advanced (T3 or Greater) prostate cancer in men undergoing robot-assisted laparoscopic prostatectomy. J Endourol 23:1519–1522PubMedCrossRef
Zurück zum Zitat Crook JM, Perry GA, Robertson S, Esche BA (1995) Routine prostate biopsies following radiotherapy for prostate cancer: results for 226 patients. Urology 45:624–631 Discussion 631–622PubMedCrossRef Crook JM, Perry GA, Robertson S, Esche BA (1995) Routine prostate biopsies following radiotherapy for prostate cancer: results for 226 patients. Urology 45:624–631 Discussion 631–622PubMedCrossRef
Zurück zum Zitat Denham JW, Steigler A, Lamb DS, Joseph D, Turner S, Matthews J et al (2011) Short-term neoadjuvant androgen deprivation and radiotherapy for locally advanced prostate cancer: 10-year data from the TROG 96.01 randomised trial. Lancet Oncol 12:451–459PubMedCrossRef Denham JW, Steigler A, Lamb DS, Joseph D, Turner S, Matthews J et al (2011) Short-term neoadjuvant androgen deprivation and radiotherapy for locally advanced prostate cancer: 10-year data from the TROG 96.01 randomised trial. Lancet Oncol 12:451–459PubMedCrossRef
Zurück zum Zitat Ficarra V, Cavalleri S, Novara G, Aragona M, Artibani W (2007) Evidence from robot-assisted laparoscopic radical prostatectomy: a systematic review. Eur Urol 51:45–55 Discussion 56PubMedCrossRef Ficarra V, Cavalleri S, Novara G, Aragona M, Artibani W (2007) Evidence from robot-assisted laparoscopic radical prostatectomy: a systematic review. Eur Urol 51:45–55 Discussion 56PubMedCrossRef
Zurück zum Zitat Fujioka T, Koike H, Aoki H, Ohhori T, Chiba R, Okamoto S (1987) Significance of staging pelvic lymphadenectomy for prostatic cancer. Urol Int 42:380–384PubMedCrossRef Fujioka T, Koike H, Aoki H, Ohhori T, Chiba R, Okamoto S (1987) Significance of staging pelvic lymphadenectomy for prostatic cancer. Urol Int 42:380–384PubMedCrossRef
Zurück zum Zitat Gao X, Qiu JG, Cai YB, Zhou XF, Hong LQ (2004) Laparoscopic radical prostatectomy. Chinese Med J-Peking 117:148–149 Gao X, Qiu JG, Cai YB, Zhou XF, Hong LQ (2004) Laparoscopic radical prostatectomy. Chinese Med J-Peking 117:148–149
Zurück zum Zitat Gao X, Wang KB, Pu XY, Zhou XF, Qiu JG (2010a) Modified apical dissection of the prostate improves early continence in laparoscopic radical prostatectomy: technique and initial results. J Cancer Res Clin Oncol 136:511–516PubMedCrossRef Gao X, Wang KB, Pu XY, Zhou XF, Qiu JG (2010a) Modified apical dissection of the prostate improves early continence in laparoscopic radical prostatectomy: technique and initial results. J Cancer Res Clin Oncol 136:511–516PubMedCrossRef
Zurück zum Zitat Gao X, Wang KB, Pu XY, Zhou XF, Qiu JG (2010b) Modified apical dissection of the prostate improves early continence in laparoscopic radical prostatectomy: technique and initial results. J Cancer Res Clin 136:511–516CrossRef Gao X, Wang KB, Pu XY, Zhou XF, Qiu JG (2010b) Modified apical dissection of the prostate improves early continence in laparoscopic radical prostatectomy: technique and initial results. J Cancer Res Clin 136:511–516CrossRef
Zurück zum Zitat Gao X, Li LY, Zhou FJ, Xie KJ, Shao CK, Su ZL et al (2012) ERG rearrangement for predicting subsequent cancer diagnosis in high-grade prostatic intraepithelial neoplasia and lymph node metastasis. Clin Cancer Res 18:4163–4172PubMedCrossRef Gao X, Li LY, Zhou FJ, Xie KJ, Shao CK, Su ZL et al (2012) ERG rearrangement for predicting subsequent cancer diagnosis in high-grade prostatic intraepithelial neoplasia and lymph node metastasis. Clin Cancer Res 18:4163–4172PubMedCrossRef
Zurück zum Zitat Gerber GS, Thisted RA, Chodak GW, Schroder FH, Frohmuller HG, Scardino PT et al (1997) Results of radical prostatectomy in men with locally advanced prostate cancer: multi-institutional pooled analysis. Eur Urol 32:385–390PubMed Gerber GS, Thisted RA, Chodak GW, Schroder FH, Frohmuller HG, Scardino PT et al (1997) Results of radical prostatectomy in men with locally advanced prostate cancer: multi-institutional pooled analysis. Eur Urol 32:385–390PubMed
Zurück zum Zitat Gontero P, Marchioro G, Pisani R, Zaramella S, Sogni F, Kocjancic E et al (2007) Is radical prostatectomy feasible in all cases of locally advanced non-bone metastatic prostate cancer? Results of a single-institution study. Eur Urol 51:922–930PubMedCrossRef Gontero P, Marchioro G, Pisani R, Zaramella S, Sogni F, Kocjancic E et al (2007) Is radical prostatectomy feasible in all cases of locally advanced non-bone metastatic prostate cancer? Results of a single-institution study. Eur Urol 51:922–930PubMedCrossRef
Zurück zum Zitat Grimm MO, Kamphausen S, Hugenschmidt H, Stephan-Odenthal M, Ackermann R, Vogeli TA (2002) Clinical outcome of patients with lymph node positive prostate cancer after radical prostatectomy versus androgen deprivation. Eur Urol 41:628–634PubMedCrossRef Grimm MO, Kamphausen S, Hugenschmidt H, Stephan-Odenthal M, Ackermann R, Vogeli TA (2002) Clinical outcome of patients with lymph node positive prostate cancer after radical prostatectomy versus androgen deprivation. Eur Urol 41:628–634PubMedCrossRef
Zurück zum Zitat Heidenreich A, Varga Z, Von Knobloch R (2002a) Extended pelvic lymphadenectomy in patients undergoing radical prostatectomy: high incidence of lymph node metastasis. J Urol 167:1681–1686PubMedCrossRef Heidenreich A, Varga Z, Von Knobloch R (2002a) Extended pelvic lymphadenectomy in patients undergoing radical prostatectomy: high incidence of lymph node metastasis. J Urol 167:1681–1686PubMedCrossRef
Zurück zum Zitat Heidenreich A, Varga Z, Von Knobloch R (2002b) Extended pelvic lymphadenectomy in patients undergoing radical prostatectomy: high incidence of lymph node metastasis. J Urol 167:1681–1686PubMedCrossRef Heidenreich A, Varga Z, Von Knobloch R (2002b) Extended pelvic lymphadenectomy in patients undergoing radical prostatectomy: high incidence of lymph node metastasis. J Urol 167:1681–1686PubMedCrossRef
Zurück zum Zitat Herrmann TR, Rabenalt R, Stolzenburg JU, Liatsikos EN, Imkamp F, Tezval H et al (2007) Oncological and functional results of open, robot-assisted and laparoscopic radical prostatectomy: does surgical approach and surgical experience matter? World J Urol 25:149–160PubMedCrossRef Herrmann TR, Rabenalt R, Stolzenburg JU, Liatsikos EN, Imkamp F, Tezval H et al (2007) Oncological and functional results of open, robot-assisted and laparoscopic radical prostatectomy: does surgical approach and surgical experience matter? World J Urol 25:149–160PubMedCrossRef
Zurück zum Zitat Jemal A, Siegel R, Xu JQ, Ward E (2010) Cancer statistics 2010. Ca-Cancer J Clin 60:277–300PubMedCrossRef Jemal A, Siegel R, Xu JQ, Ward E (2010) Cancer statistics 2010. Ca-Cancer J Clin 60:277–300PubMedCrossRef
Zurück zum Zitat Karakiewicz PI, Hutterer GC (2008) Predictive models and prostate cancer. Nat Clin Pract Urol 5:82–92PubMedCrossRef Karakiewicz PI, Hutterer GC (2008) Predictive models and prostate cancer. Nat Clin Pract Urol 5:82–92PubMedCrossRef
Zurück zum Zitat Meeks JJ, Zhao L, Greco KA, Macejko A, Nadler RB (2009) Impact of prostate median lobe anatomy on robotic-assisted laparoscopic prostatectomy. Urology 73:323–327PubMedCrossRef Meeks JJ, Zhao L, Greco KA, Macejko A, Nadler RB (2009) Impact of prostate median lobe anatomy on robotic-assisted laparoscopic prostatectomy. Urology 73:323–327PubMedCrossRef
Zurück zum Zitat Oliveira IS, Pontes J, Abe DK, Crippa A, Dall’Oglio MF, Nesralah AJ et al (2010) Undergrading and understaging in patients with clinically insignificant prostate cancer who underwent radical prostatectomy. Int Braz J Urol 36:292–298PubMed Oliveira IS, Pontes J, Abe DK, Crippa A, Dall’Oglio MF, Nesralah AJ et al (2010) Undergrading and understaging in patients with clinically insignificant prostate cancer who underwent radical prostatectomy. Int Braz J Urol 36:292–298PubMed
Zurück zum Zitat Peyromaure M, Debre B, Mao K, Zhang GQ, Wang YR, Sun ZQ et al (2005) Management of prostate cancer in China: a multicenter report of 6 institutions. J Urol 174:1794–1797PubMedCrossRef Peyromaure M, Debre B, Mao K, Zhang GQ, Wang YR, Sun ZQ et al (2005) Management of prostate cancer in China: a multicenter report of 6 institutions. J Urol 174:1794–1797PubMedCrossRef
Zurück zum Zitat Peyromaure M, Mao KL, Sun YH, Xia SJ, Jiang N, Zhang SQ et al (2009) A comparative study of prostate cancer detection and management in China and in France. Can J Urol 16:4472–4477PubMed Peyromaure M, Mao KL, Sun YH, Xia SJ, Jiang N, Zhang SQ et al (2009) A comparative study of prostate cancer detection and management in China and in France. Can J Urol 16:4472–4477PubMed
Zurück zum Zitat Quinn DI, Henshall SM, Haynes AM, Brenner PC, Kooner R, Golovsky D et al (2001) Prognostic significance of pathologic features in localized prostate cancer treated with radical prostatectomy: implications for staging systems and predictive models. J Clin Oncol 19:3692–3705PubMed Quinn DI, Henshall SM, Haynes AM, Brenner PC, Kooner R, Golovsky D et al (2001) Prognostic significance of pathologic features in localized prostate cancer treated with radical prostatectomy: implications for staging systems and predictive models. J Clin Oncol 19:3692–3705PubMed
Zurück zum Zitat Schumacher MC, Burkhard FC, Thalmann GN, Fleischmann A, Studer UE (2006) Is pelvic lymph node dissection necessary in patients with a serum PSA <10 ng/ml undergoing radical prostatectomy for prostate cancer? Eur Urol 50:272–279PubMedCrossRef Schumacher MC, Burkhard FC, Thalmann GN, Fleischmann A, Studer UE (2006) Is pelvic lymph node dissection necessary in patients with a serum PSA <10 ng/ml undergoing radical prostatectomy for prostate cancer? Eur Urol 50:272–279PubMedCrossRef
Zurück zum Zitat Stock RG, Stone NN, Kao J, Iannuzzi C, Unger P (2000) The effect of disease and treatment-related factors on biopsy results after prostate brachytherapy: implications for treatment optimization. Cancer 89:1829–1834PubMedCrossRef Stock RG, Stone NN, Kao J, Iannuzzi C, Unger P (2000) The effect of disease and treatment-related factors on biopsy results after prostate brachytherapy: implications for treatment optimization. Cancer 89:1829–1834PubMedCrossRef
Zurück zum Zitat Thurairaja R, Studer UE, Burkhard FC (2009) Indications, extent, and benefits of pelvic lymph node dissection for patients with bladder and prostate cancer. Oncologist 14:40–51PubMedCrossRef Thurairaja R, Studer UE, Burkhard FC (2009) Indications, extent, and benefits of pelvic lymph node dissection for patients with bladder and prostate cancer. Oncologist 14:40–51PubMedCrossRef
Zurück zum Zitat Van Baelen A, Mottet N, Spahn M, Briganti A, Gontero P, Joniau S (2012) Sense and nonsense of an extended pelvic lymph node dissection in prostate cancer. Adv Urol 2012:983058PubMed Van Baelen A, Mottet N, Spahn M, Briganti A, Gontero P, Joniau S (2012) Sense and nonsense of an extended pelvic lymph node dissection in prostate cancer. Adv Urol 2012:983058PubMed
Zurück zum Zitat Van Poppel H, Joniau S (2008) An analysis of radical prostatectomy in advanced stage and high-grade prostate cancer. Eur Urol 53:253–259PubMedCrossRef Van Poppel H, Joniau S (2008) An analysis of radical prostatectomy in advanced stage and high-grade prostate cancer. Eur Urol 53:253–259PubMedCrossRef
Zurück zum Zitat Van Poppel H, Vekemans K, Da Pozzo L, Bono A, Kliment J, Montironi R et al (2006) Radical prostatectomy for locally advanced prostate cancer: results of a feasibility study (EORTC 30001). Eur J Cancer 42:1062–1067PubMedCrossRef Van Poppel H, Vekemans K, Da Pozzo L, Bono A, Kliment J, Montironi R et al (2006) Radical prostatectomy for locally advanced prostate cancer: results of a feasibility study (EORTC 30001). Eur J Cancer 42:1062–1067PubMedCrossRef
Zurück zum Zitat Ward JF, Zincke H (2003) Radical prostatectomy for the patient with locally advanced prostate cancer. Curr Urol Rep 4:196–204PubMedCrossRef Ward JF, Zincke H (2003) Radical prostatectomy for the patient with locally advanced prostate cancer. Curr Urol Rep 4:196–204PubMedCrossRef
Zurück zum Zitat Warde P, Mason M, Ding K, Kirkbride P, Brundage M, Cowan R et al (2011) Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial. Lancet 378:2104–2111PubMedCrossRef Warde P, Mason M, Ding K, Kirkbride P, Brundage M, Cowan R et al (2011) Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial. Lancet 378:2104–2111PubMedCrossRef
Metadaten
Titel
Laparoscopic radical prostatectomy plus extended lymph nodes dissection for cases with non-extra node metastatic prostate cancer: 5-year experience in a single Chinese institution
verfasst von
Ming-Kun Chen
Yun Luo
Hao Zhang
Jiang-Guang Qiu
Xin-Qiao Wen
Jun Pang
Jie Si-Tu
Qi-Peng Sun
Xin Gao
Publikationsdatum
01.05.2013
Verlag
Springer-Verlag
Erschienen in
Journal of Cancer Research and Clinical Oncology / Ausgabe 5/2013
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-013-1395-3

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