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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.
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PURPOSE: To investigate oncological outcomes based on bladder cuff excision (BCE) during radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) and to provide clinical evidence of tumor recurrence in patients without BCE. MATERIALS AND METHODS: We retrospectively collected data of 372 consecutive patients who underwent RNU at our institution from May 1989 through October 2010. After excluding some data, we reviewed 336 patients for the analysis. RESULTS: Of the patients who underwent RNU with BCE (n=279, 83.0%) and without BCE (n=57, 17.0%), patients without BCE had poorer cancer-specific and overall survival rates. Among 57 patients without BCE, 35 (61.4%) experienced tumor recurrence. Recurrence at the remnant ureter resulted in poor oncological outcomes compared to those in patients with bladder recurrence, but better outcomes were observed compared to recurrence at other sites. No significant predictors for tumor recurrence at the remnant ureter were identified. In patients without BCE, pathological T stage [hazard ratio (HR), 5.73] and lymphovascular invasion (HR, 3.65) were independent predictors of cancer-specific survival, whereas age (HR, 1.04), pathological T stage (HR, 5.11), and positive tumor margin (HR, 6.50) were independent predictors of overall survival. CONCLUSION: Patients without BCE had poorer overall and cancer-specific survival after RNU than those with BCE. Most of these patients experienced tumor recurrence at the remnant ureter and other sites. Patients with non-organ confined UTUC after RNU without BCE may be considered for adjuvant chemotherapy with careful follow-up.