Comparison of biochemical recurrence rate and oncologic outcomes between anterior and lateral approach to laparoscopic radical prostatectomy
DOI:
https://doi.org/10.52786/isu.a.110Keywords:
Prostate cancer, lateral approach laparoscopic prostatectomy, laparoscopic radical prostatectomyAbstract
Objective: Malignancy of the prostate is the fourth most common malignancy in older Thai men. At present, laparoscopic prostatectomy is one of the most common forms of treatment for prostate cancer. In Rajavithi Hospital, two different approaches are used to carry out a laparoscopic prostatectomy, the anterior approach and the lateral approach. The aim of this study was to compare the oncologic outcomes between the two approaches and to follow the biochemical recurrence rate after surgery. The pathological, oncological outcomes between an anterior approach laparoscopic prostatectomy (AA-LRP) and a lateral approach laparoscopic prostatectomy (LA-LRP) were compared with a focus on pathologic outcomes including free margin, lymphovascular invasion, and seminal vesical invasion.
Materials and Methods: A retrospective review was carried out using prospectively collected data on 230 patients who underwent AA-LRP (n = 96) and LA-LRP (n = 134) carried out by a single surgeon between January 2005 and December 2022. Pathological and biochemical recurrence were also examined.
Results: No statistical significance was found in overall oncologic outcomes between the AA-LRP and LA-LRP, positive margin between the anterior approach (32.7%) and lateral approach (42.4%) (p = 0.166). No statistically significant differences were found regarding LVI-positive and seminal vesicle-positive between the two techniques. Kaplan–Meier analysis did not show any statistically significant differences with respect to biochemical recurrence between the two approaches, specifically anterior approach (mean follow-up 108 months) no biochemical recurrence = 73.0% lateral approach (mean follow-up 78 months) no biochemical recurrence = 66.7% (p = 0.371).
Conclusion: We conclude from this data from our institute that there was no statistically significant difference in oncologic outcome and biochemical recurrence rate in this single-surgeon comparative series between AA-LRP and LA-LRP. Further prospective studies are warranted to determine whether any particular technique is superior to the other in oncologic outcomes and biochemical recurrence rate.
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