Abstract
Objectives There is a little published data on the outcomes of radical prostatectomy in the
Irish context. We aimed to determine the 5-year oncological results of open radical
retropubic prostatectomy (RRP) performed by a single surgeon following appointment.
Methods A retrospective review of RRPs performed between 2011 and 2016 was conducted. Patient
demographics, preoperative parameters (clinical stage on digital rectal exam, prostate-specific
antigen (PSA) levels, biopsy Gleason's score and MRI [magnetic resonance imaging]
findings), pathological variables (T-stage, Gleason's score, nodal status, and surgical
margin status), and treatment decisions (lymphadenectomy or adjuvant radiotherapy)
were recorded. Oncological outcome at last follow-up was ascertained.
Results 265 patients underwent RRP between 2011 and 2016. Median age was 62 years (range:
41–74). Mean follow-up was 32.24 months (range: 8–72) months. Pathological disease
stage was T2 in 170/265 (64.15%), T3a in 65/265 (24.53%), and T3b in 30/265 (11.32%).
Final Gleason's score was upgraded from diagnostic biopsy in 16.35% (43/263) and downgraded
in 27% (71/263). Pelvic lymph node dissection was performed in 44.25% (118/265) patients.
A positive surgical margin (PSM) was seen in 26/170 (15.2%) patients with T2 disease
and in 45/95 (47.37%) patients with T3 disease. Of the 265 patients, 238 (89.81%)
were disease-free at last follow-up, of whom 24/238 (10.08%) had received adjuvant
and 17/238 (7.14%) received salvage radiotherapy. Adjuvant/salvage treatment was ongoing
in 19/265 (7.17%) of patients.
Conclusion Good oncological outcomes of RRP in the Irish context are seen in this 5-year review,
with the vast majority of patients experiencing biochemical-free survival at most
recent follow-up.
Keywords
radical retropubic prostatectomy - RRP - open prostatectomy - prostate cancer - oncological
outcomes
