Comparison of oncologic and functional outcomes by retropubic and laparoscopic radical prostatectomy for the treatment of localized and locally advanced prostate cancer

Objective To compare the oncologic and functional outcomes of retropubic radical prostatectomy (RRP) and laparoscopic radical prostatectomy (LRP) for the treatment of localized and locally advanced prostate cancer (PCa). Methods From October 2000 to December 2013, 729 PCa cases who underwent radical prostatectomy were retrospectively analyzed. Of the 729 patients, 164 cases underwent RRP while 565 cases conducted LRP. The median age in RRP and LRP groups was 69 (38–84) years and 69 (39–88) years, median follow–up time was 58 (18–153) months and 66 (19–174) months, respectively. All the cases were stratified into localized (RRP 78 cases, LRP 370 cases) and locally advanced (RRP 86, LRP 195) PCa according to pathological TNM stage. Positive surgical margins (PSM), 1– and 2–year urinary continence, potency, 5–year biochemical recurrence–free survival and 5–year cancer–specific survival were recorded and analyzed between RRP and LRP groups. Results In localized and locally advanced cases between the 2 groups (RRP versus LRP), PSM rates were 11.5% versus 13.8%, 31.4% versus 32.8%, 5–year biochemical recurrence free rates were 79.7% versus 85.6%, 46.8% versus 50.6%, and 5–year cancer–specific survival rates were 97.8% versus 98.8%, 85.3% versus 91.2%. There was no significant difference between RRP and LRP groups (P>0.05). The 1– and 2–year urinary continence rates (RRP versus LRP) in localized PCa were 87.2% versus 92.7%, 97.4% versus 96.5%, respectively (P>0.05). The 1– and 2–year urinary continence rates (RRP versus LRP) in locally advanced PCa were 76.7% versus 85.1%, 88.4% versus 90.8%, respectively (P>0.05). The difference was significantly observed regarding potency between RRP and LRP groups (42.6% versus 59.0%, P<0.05) in patients with localized PCa. Conclusions The oncological and functional outcomes between RRP and LRP are comparable both in localized and locally advanced PCa. LRP had advantage on erectile functional recovery over RRP. Key words: Prostatic neoplasms; Prostatectomy; Laparoscopes; Open surgery