Treatment of Prostate Cancer—The Clinical Use of Radical Prostatectomy

Abstract

Objective: To discuss the clinical use of radical prostatectomy in patients with clinically localized prostate cancer regarding outcome, quality of life, and morbidity based on own data and results of the literature.

Methods: A review of the currently available literature was performed. Moreover, data of 1755 patients who underwent radical retropubic prostatectomy between 1992 and 2001 at our institution were analyzed in uni- and multivariate analyses and included.

Results: Disease-free survival of about 80% over a 5-year period are reported. Pathologic stage and the Gleason score are the most influencing factors on postoperative outcome. Continence rates of about 90% are common; nerve-sparing radical prostatectomy seemed to have a protecting factor on continence. Rates of erection depend on the extent of nerve-sparing and achieve up to 90% after bilateral nerve-sparing. 30-days perioperative morbidity decreased to less than 5% in major series with a mortality rate of nil.

Conclusions: Selecting the right patient with clinically localized disease, radical prostatectomy showed excellent data on long-term follow-up. Due to respectful understanding of anatomical structures and improvements in surgical techniques, morbidity of the operation decreased and with the nerve-sparing technique quality of life increased.