Subject(s)
Angiomyolipoma/diagnostic imaging , Astrocytoma/diagnosis , Brain Neoplasms/diagnosis , Hemorrhage/diagnostic imaging , Kidney Neoplasms/diagnostic imaging , Neoplasms, Multiple Primary/diagnostic imaging , Tuberous Sclerosis/complications , Angiomyolipoma/complications , Astrocytoma/complications , Brain Neoplasms/complications , Female , Hemorrhage/etiology , Humans , Kidney Neoplasms/complications , Magnetic Resonance Imaging , Neoplasms, Multiple Primary/complications , Radiography , Young AdultABSTRACT
PURPOSE: Kattan and Stephenson nomograms are based on the outcomes of patients with prostate cancer recruited in the USA, but their applicability to Chinese patients is yet to be validated. We aim at studying the predictive accuracy of these nomograms in the Chinese population. PATIENTS AND METHODS: A total of 408 patients who underwent laparoscopic or open radical resection of prostate from 1995 to 2009 were recruited. The preoperative clinical parameters of these patients were collected, and they were followed up regularly with PSA monitored. Biochemical recurrence was defined as two or more consecutive PSA levels >0.4 ng/mL after radical resection of prostate or secondary cancer treatment. RESULTS: The overall observed 5-year and 10-year biochemical recurrence-free survival rates were 68.3% and 59.8%, which was similar to the predicted values by the Kattan and Stephenson nomograms, respectively. The results of our study achieved a good concordance with both nomograms (Kattan: 5-years, 0.64; Stephenson: 5-years, 0.62, 10-years, 0.71). CONCLUSIONS: The incidence of prostate cancer in Hong Kong is increasing together with the patients' awareness of this disease. Despite the fact that Kattan nomograms were derived from the western population, it has been validated in our study to be useful in Chinese patients as well.
Subject(s)
Neoplasm Recurrence, Local/diagnosis , Nomograms , Prostatectomy/methods , Prostatic Neoplasms/diagnosis , Asian People , Disease-Free Survival , Follow-Up Studies , Humans , Incidence , Kallikreins/analysis , Kaplan-Meier Estimate , Male , Neoplasm Grading , Predictive Value of Tests , Preoperative Period , Prostate-Specific Antigen/analysis , Prostatic Neoplasms/epidemiology , Prostatic Neoplasms/metabolismABSTRACT
OBJECTIVE: To summarise our experience of laparoscopic radical prostatectomy in a single centre in Hong Kong over 5 years. DESIGN: Retrospective study. SETTING: Urology Division, Department of Surgery, Tuen Mun Hospital, Hong Kong. PATIENTS: A total of 87 patients who underwent laparoscopic radical prostatectomy from March 2002 to May 2007. MAIN OUTCOME MEASURES: Peri-operative data and follow-up information. RESULTS: The operative procedure used entailed Montsouris technique and its modifications, including the latest method involving the extraperitoneal descending technique. In all, 87 patients underwent the operation; in two, the procedure was converted to open surgery. Peri-operative parameters which showed improvement included: operating time, blood loss, resort to blood transfusions, and the complication rate. There was no operation-related mortality. In organ-confined disease, a clear surgical margin was achieved in 93% of the patients, but in those whose disease was not organ-confined, the positive margin rate was 87%. Among patients with organ-confined disease, 13% had evidence of biochemical recurrence. Hormonal therapy was started in five patients, none of whom died during the follow-up period (mean, 24 months). Continence recovered in 69% of the patients by 6 months and in 92% by 12 months post-surgery. Assessment of erectile function before and after the surgery was problematic and estimated to be 20% among patients having the nerve-sparing procedure performed. CONCLUSION: Although Hong Kong has a relatively low incidence for prostate cancer, it was possible to develop laparoscopic radical prostatectomy with acceptable early results. Further follow-up is warranted before formulating definitive conclusions about this procedure.
