Clinical and Pathological Outcomes of Laparoscopic Radical Prostatectomy in a Large Volume Center in the Philippines: A Ten-year Experience

Abstract

Introduction: Currently, there are limited studies on laparoscopic radical prostatectomy (LRP) in the country. The authors report the clinical and oncological outcomes of LRP over a 10-year experience in a large volume center in the Philippines.

Methods: This retrospective study included 101 patients treated consecutively with LRP from 2008 to 2017. Patient demographics, preoperative prostate features, perioperative data and complications were summarized to determine surgical outcomes. Histopathological results were analyzed to determine oncological efficacy.

Results: The mean age was 64.8-7.1 years (R:46-84), BMI was 25.3±3.0 kg/m2 (R:18.7-34.1), prostate volume was 41.1+21.2g (R:7.9-133) and preoperative PSA was 21.5+19.9 ng/mL (R:2.0-100). Operative time was 276.1+70.0 mins. (R:165-475) and estimated blood loss was 604.7+478.4 mL (R: 100-3700). Five (5%) required conversion to open. Time to oral intake was 1.3+0.7 days (R:1-5). Bowel function returned in 2.0+0.9 days (R: 1-4). The drain was removed after 3.7+1.2 days (R:0-9) in 89 patients while 12 patients were discharged with the surgical drain. The length of stay was 4.5+1.8 days (R: 3-14). Pathologically, 26 (25.7%) had extracapsular extension and 14 (13.8%) had seminal vesicle involvement. Three out of 44 (6.8%) who had pelvic lymphadenectomy had nodal metastasis. Thirty (29.7%) had positive surgical margins, the most common site being the apex (17, 56.6%). Thirty-one (30.6%) had Grade I to III complications. There was no mortality.

Conclusion: Laparoscopic radical prostatectomy continues to be a feasible minimally invasive alternative treatment for localized prostate cancer with an acceptable safety profile and high oncological efficiency.