Article

Radical prostatectomy reigns supreme.

Division of Urologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Oncology (Williston Park, N.Y.) (impact factor: 1.03). 09/2009; 23(10):863-7. pp.863-7
Source: PubMed

ABSTRACT The clinical incidence of prostate cancer continues to increase in the patient population, while the actual mortality has remained relatively low. As clinicians, we struggle to identify those patients who require intervention for their disease and to determine which treatment modality is best. Active surveillance, brachytherapy, external-beam radiation therapy, and surgical radical prostatectomy (RP) are the current options for prostate cancer treatment, each with a distinct impact on a patient's health-related quality of life. We believe that for the majority of patients with organ-confined prostate cancer, RP remains the gold standard with respect to both oncologic success and maximization of quality of life. Herein we discuss the advantages of RP.

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    Article: Contemporary radical prostatectomy.
    Qiang Fu, Judd W Moul, Leon Sun
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    ABSTRACT: Purpose. Patients diagnosed with clinically localized prostate cancer have more surgical treatment options than in the past. This paper focuses on the procedures' oncological or functional outcomes and perioperative morbidities of radical retropubic prostatectomy, radical perineal prostatectomy, and robotic-assisted laparoscopic radical prostatectomy. Materials and Methods. A MEDLINE/PubMed search of the literature on radical prostatectomy and other new management options was performed. Results. Compared to the open procedures, robotic-assisted radical prostatectomy has no confirmed significant difference in most literatures besides less blood loss and blood transfusion. Nerve sparing is a safe means of preserving potency on well-selected patients undergoing radical prostatectomy. Positive surgical margin rates of radical prostatectomy affect the recurrence and survival of prostate cancer. The urinary and sexual function outcomes have been vastly improved. Neoadjuvant treatment only affects the rate of positive surgical margin. Adjuvant therapy can delay and reduce the risk of recurrence and improve the survival of the high risk prostate cancer. Conclusions. For the majority of patients with organ-confined prostate cancer, radical prostatectomy remains a most effective approach. Radical perineal prostatectomy remains a viable approach for patients with morbid obesity, prior pelvic surgery, or prior pelvic radiation. Robot-assisted laparoscopic prostatectomy (RALP) has become popular among surgeons but has not yet become the firmly established standard of care. Long-term data have confirmed the efficacy of radical retropubic prostatectomy with disease control rates and cancer-specific survival rates.
    Prostate cancer. 01/2011; 2011:645030.
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Keywords

Active surveillance
 
actual mortality
 
brachytherapy
 
distinct impact
 
external-beam radiation therapy
 
gold standard
 
Herein
 
low
 
oncologic success
 
organ-confined prostate cancer
 
prostate cancer
 
prostate cancer treatment
 
surgical radical prostatectomy
 
treatment modality
 

Heidi J Rayala