Document Detail

Prospective evaluation of combined oncological and functional outcomes after laparoscopic radical prostatectomy: trifecta rate of achieving continence, potency and cancer control at 2 years.
MedLine Citation:
PMID:  20575978     Owner:  NLM     Status:  In-Process    
OBJECTIVE: To determine the proportion of patients who are continent, potent and cancer-free (trifecta rate) 2 years after extraperitoneal laparoscopic radical prostatectomy (ELRP).
PATIENTS AND METHODS: We included patients who underwent an ELRP at our department and who were followed for at least 2 years. Those who were impotent or incontinent before the surgery were excluded from the analysis. Overall, 911 men were included. All patients prospectively completed objective, self-administered questionnaires before the medical visit, concerning their voiding and sexual disorders, before surgery and 12 and 24 months after ELRP. Biochemical recurrence was defined as any detectable serum PSA (≥ 0.2 ng/mL). Potency was defined as the ability to achieve an erection sufficient for penetration with or without the use of phosphodiesterase-5 enzyme inhibitor. Urinary continence was defined as absence, or occasional use, of a pad for anticipated vigorous activity. The primary study endpoint was the trifecta rate (cancer control, continence and potency) at 2 years after the surgery. Factors associated with the trifecta outcome were assessed in univariate analysis.
RESULTS: Median age and PSA level were 62.2 years and 9.9 ng/mL, respectively. A trifecta outcome was achieved in 29.7 and 54.4% of patients at 12 and 24 months, respectively. The 2-year trifecta rate reached 63.5% in patients undergoing bilateral nerve-sparing surgery and 73.5% in men aged < 60 years. Age < 60 years, PSA level < 10 ng/mL, organ-confined disease and bilateral nerve-sparing procedure were significantly associated with the 2-year trifecta outcome. A total of 84.8% of patients were both cancer-free and continent at 24 months, regardless of erectile function.
CONCLUSIONS: Two years after ELRP, the trifecta outcome is achieved in 54.4% of patients who remained potent and continent. This rate reaches 63.5% in patients undergoing a bilateral nerve-sparing procedure. Combined results of good cancer control and continence recovery are reported in 84.8% of patients, regardless of erectile function.
Guillaume Ploussard; Alexandre de la Taille; Evanguelos Xylinas; Yves Allory; Dimitri Vordos; Andras Hoznek; Claude Clément Abbou; Laurent Salomon
Related Documents :
11750248 - Minimally invasive therapies for benign prostatic hyperplasia.
12664068 - Potency after unilateral nerve sparing surgery: a report on functional and oncological ...
1690308 - Significance of predominantly irritative symptomatology before a prostatic operation.
19727818 - Quality of life among elderly men treated for prostate cancer with either radical prost...
22376088 - The effect of short time periods of pre-operative warming in the prevention of peri-ope...
23538178 - Cost-effectiveness analysis of early versus late total hip replacement in italy.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJU international     Volume:  107     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  274-9     Citation Subset:  IM    
Copyright Information:
INSERM U955 EQ7, Department of Urology, CHU Henri Mondor, Créteil, France.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Superficial dorsal penile vein thrombosis: a little-known complication of subinguinal varicocelectom...
Next Document:  Nicorandil-induced penile ulcerations: a case series.