Mishra Shashikant, Agrawal Vikas, Khatri Naushad, Sharma Rajan, Kurien Abraham, Ganpule Arvind, Muthu V, Sabnis Ravindra B, Desai Mahesh R
Department of Urology, Muljibhai Patel Urological Hospital, Nadaid, Gujarat, India.
Indian J Urol. 2012 Jan;28(1):32-6. doi: 10.4103/0970-1591.94953.
There is a lack of published data on laparoscopic radical prostatectomy (LRP) in India. Although the published short-term oncologic outcomes after LRP are encouraging, intermediate and long-term data are lacking.
We analyzed the oncological outcome after LRP based on 6 years of experience and compared it with the other single-center published literature.
Of the 90 patients who underwent LRP for a clinical T2 localized disease, 73 patients with at least a follow up of one year were analyzed. Patients were classified as low-, intermediate-, and high-risk D'Amico groups in 22 (30%), 26 (36%), and 25 (34%) of the patient population, respectively. Progression of disease was defined as a PSA of 0.4ng/ml with a confirmatory rise. We used Kaplan-Meier product limit estimates to calculate actuarial 5-year probabilities of biochemical progression-free survival. Univariate analysis of risk factors for biochemical recurrence (BCR) was done.
The mean age of the patients was 63.3 ± 6.6 years. The average follow-up for patients was 22 (12-72) months. There was no prostatic cancer-specific mortality. Fourteen patients had BCR. The 5-year progression-free probability for men with low-, intermediate-, and high-risk prostate cancers was 91%, 82%, and 58%, respectively. High-risk group, Gleason sum more than 8, extracapsular extension, and positive surgical margin were significantly associated with biochemical progression.
LRP provided a similar level of oncological success as reported by the other contemporary single-center published literature.
印度缺乏关于腹腔镜根治性前列腺切除术（LRP）的已发表数据。尽管已发表的LRP术后短期肿瘤学结果令人鼓舞，但缺乏中期和长期数据。
我们基于6年的经验分析了LRP后的肿瘤学结果，并将其与其他单中心发表的文献进行比较。
在90例行LRP治疗临床T2期局限性疾病的患者中，分析了73例至少随访1年的患者。患者分别被分为低危、中危和高危D'Amico组，分别占患者总数的22例（30%）、26例（36%）和25例（34%）。疾病进展定义为前列腺特异性抗原（PSA）为0.4ng/ml且有确认性升高。我们使用Kaplan-Meier乘积限估计法计算无生化进展生存的精算5年概率。对生化复发（BCR）的危险因素进行单因素分析。
患者的平均年龄为63.3±6.6岁。患者的平均随访时间为22（12 - 72）个月。无前列腺癌特异性死亡。14例患者发生BCR。低危、中危和高危前列腺癌男性的5年无进展概率分别为91%、82%和58%。高危组、 Gleason评分总和超过8分、包膜外侵犯和手术切缘阳性与生化进展显著相关。
LRP提供了与其他当代单中心发表文献报道相似水平的肿瘤学成功率。
