Urology and Andrology

Oncological and functional outcomes of radical prostatectomy in incidental cancer

Objective. Analysis of oncological and functional outcomes of radical prostatectomy (RPE) in patients with prostate cancer (PC) at stages Т1a-b N0M0 and T1сN0M0.
Patients and methods. The treatment group included patients with PC Т1a-b N0M0 (n = 33), the control group – with localised PC T1сN0M0 (n = 33). The patients’ age was 62.6 years (group 1) and 63.3 years (group 2). The average time between the removal of prostatic hyperplasia (BPG) and RPE was 5 months. Oncological outcomes were assessed by the presence of positive surgical margin, biochemical and clinical recurrences, functional outcomes – by incontinence severity (ICIQ-SF questionnaire, positive/negative PAD test made after 3, 6, 9, 12 months).
Results. The follow-up time for patients in the treatment group averaged 46.8 months, in the control group – for 39.4 months. Biochemical recurrence of PC was found in 3 cases (9.09%), 1 case (3.03%) in group 1 necessitated radiation therapy. The negative PAD test made 6 months post-surgery was obtained in 25 (75.75%) patients of the treatment group and in 30 (90.9%) in the control group, 12 months post-surgery – in 29 (87.87%) of the treatment group and in 32 (96.9%) of the control group. The positive PAD test of varied degree persisted during the follow-up period of more than 12 months in 4 patients of the treatment group and in 1 patients of the control group.
Conclusions. RPE in patients with a history of surgery due to BPH is characterised by a comparatively good oncological and functional outcomes. The risk of intra- and postoperative complications is insignificantly higher than in patients with stage T1c,
which is contributed by accumulation of the experience of such operations, increased proportion of robotic surgery and observance of measures aimed at preventing complications.
Key words: incidental prostate cancer, prostate, radical prostatectomy, robotic laparoscopic radical prostatectomy, transurethral resection of prostate.
For citation: Fokin I.V., Rapoport L.M., Bezrukov E.A., Shpot E.V., Demidko Yu.L., Lobanov M.V., Shchelokova E.E., Chuvalov L.L., Paramonova N.B., Stepanov A.V., Enikeev M.E. Oncological and functional outcomes of radical prostatectomy in incidental cancer. Vopr. urol. androl. (Urology and Andrology). 2019; 7(3): 22–28. (In Russian). DOI: 10.20953/2307-6631-2019-3-22-28