Prostate cancer relapse among laparoscopic prostatectomy patients. Experience in a Latin American hospital

Prostate cancer relapse among laparoscopic prostatectomy patients. Experience in a Latin American hospital

Carlos E. Montes-Cardona 1 , Gerardo Mondragón 2 , Juliana Gutiérrez 2 , Alexandra Mendoza-Cruz 1 , Sebastián Romero-Fernández 3 , Oriana Arias-Valderrama 4 , Manuel Duque-Galán 1

1 Departamento de Urología, Fundación Valle del Lili, Cali, Colombia; 2 Facultad de Ciencias de la Salud, Departamento de Medicina, Universidad Icesi, Cali, Colombia; 3 Centro de Investigaciones Clínicas, Fundación Valle del Lili. Cali, Colombia; 4 Facultad de Ciencias de la Salud, Departamento de Medicina, Universidad Icesi, Cali, Colombia; Centro de Investigaciones Clínicas, Fundación Valle del Lili. Cali, Colombia

*Correspondence: Carlos E. Montes-Cardona. Email: carlos.montes.ca@fvl.org.co

Abstract

Objective: To describe the clinical characteristics, intra- and post-surgical complications, and oncological outcomes of patients undergoing laparoscopic radical prostatectomy in a high-complexity center in the city of Cali, Colombia.

Method: Observational retrospective cohort study between 2011 and 2021. Patients undergoing laparoscopic prostatectomy with diagnosis of prostate cancer were included. They were classified as low, medium and high risk according to prostate specific antigen (PSA) and clinical TNM. They were grouped according to the International Society of Urological Pathology (ISUP) scale. The D’Amico classification determined the risk of biochemical recurrence. A 60-month survival analysis was performed according to the Kaplan-Meier method. Factors related to relapse and the probability of disease-free time were estimated with univariate and multivariate Cox regression.

Results: Three hundred and seventy-nine patients were included. The median initial PSA was 8.3. Twenty-five-point thirty-four percent were classified as locally advanced pathology. The 5-year overall survival was 97%. Patients with biochemical persistence with locally advanced disease had a 44% probability of relapse. The 5-year probability of relapse in high-risk patients was 35%.

Conclusions: The risk factor with the greatest impact on oncological relapse at 60 months is biochemical persistence 6 months after the procedure. Patients with high risk according to the D’Amico classification had a greater relapse.

Keywords: Prostate cancer; Radical prostatectomy; Quality of life; Urinary incontinence; Erectile dysfunction; Comorbidity

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