Journal of Yeungnam Medical Science

Original Article

Oncological and functional outcomes following robot-assisted laparoscopic radical prostatectomy at a single institution: a minimum 5-year follow-up: Jun-Koo Kang, Jae-Wook Chung, So Young Chun, Yun-Sok Ha, Seock Hwan Choi, Jun Nyung Lee, Bum Soo Kim, Ghil Suk Yoon, Hyun Tae Kim, Tae-Hwan Kim, Tae Gyun Kwon; Yeungnam Univ J Med. 2018;35(2):171-178. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.171

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Background
To evaluate mid-term oncological and functional outcomes in patients with prostate cancer treated by robot-assisted laparoscopic radical prostatectomy (RALP) at our institution.
Methods
We retrospectively reviewed the medical records of 128 patients with prostate cancer who underwent RALP at our institution between February 2008 and April 2010. All patients enrolled in this study were followed up for at least 5 years. We analyzed biochemical recurrence (BCR)-free survival using a Kaplan-Meier survival curve analysis and predictive factors for BCR using multivariate Cox regression analysis. Continence recovery rate, defined as no use of urinary pads, was also evaluated.
Results
Based on the D’Amico risk classification, there were 30 low-risk patients (23.4%), 47 intermediaterisk patients (38.8%), and 51 high-risk patients (39.8%), preoperatively. Based on pathological findings, 50.0% of patients (64/128) showed non-organ confined disease (≥T3a) and 26.6% (34/128) had high grade disease (Gleason score ≥8). During a median follow-up period of 71 months (range, 66-78 months), the frequency of BCR was 33.6% (43/128) and the median BCR-free survival was 65.9 (0.4-88.0) months. Multivariate Cox regression analysis revealed that high grade disease (Gleason score ≥8) was an independent predictor for BCR (hazard ratio=4.180, 95% confidence interval=1.02-17.12, p=0.047). In addition, a majority of patients remained continent following the RALP procedure, without the need for additional intervention for post-prostatectomy incontinence.
Conclusion
Our study demonstrated acceptable outcomes following an initial RALP procedure, despite 50% of the patients investigated demonstrating high-risk features associated with non-organ confined disease.

Citations

Citations to this article as recorded by

Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy
Ching-Wei Yang, Hsiao-Hsien Wang, Mohamed Fayez Hassouna, Manish Chand, William J. S. Huang, Hsiao-Jen Chung
Scientific Reports.2021;[Epub] CrossRef

Review Article

Functional recovery after radical prostatectomy for prostate cancer: Young Hwii Ko; Yeungnam Univ J Med. 2018;35(2):141-149. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.141

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Abstract PDF

With the enthusiasm regarding robotic application in radical prostatectomy in accordance with the widespread use of serum prostate-specific antigen as a screening test, the number of surgeries performed for complete removal of the gland is increasing continuously. However, owing to the adjacent anatomical location of the prostate to the nerve and urethral sphincter complex, functional recovery, namely improvement from post-prostatectomy incontinence (PPI) and post-prostatectomy erectile dysfunction, still remains a main problem for patients who are reluctant to undergo surgery and tend to choose alternative ways instead. Since the late 1980s, the introduction of radical prostatectomy by open surgical modalities, the depth of the anatomical understanding of the structure surrounding the prostate is getting tremendous, which leads to the development of new surgical modalities and techniques that are consequently aimed at reducing the incidences of PPI and erectile dysfunction. Briefly, recent data from robotic radical prostatectomy, particularly on PPI, are quite acceptable, but by contrast, the reported potency regain rate still remains <20%, which indicates the need for advanced surgical modification to overcome it. In this review, the authors summarized the recent findings on the anatomy and surgical techniques reported up to now.

Citations

Citations to this article as recorded by

The assessment of erectile dysfunction after radical prostatectomy using pudendal somatosensory evoked potential
Se Yun Kwon, Jin-Mo Park, Appuwawadu Mestri Nipun Lakshitha de Silva
PLOS ONE.2023; 18(11): e0292847. CrossRef
Fidgetin-like 2 negatively regulates axonal growth and can be targeted to promote functional nerve regeneration
Lisa Baker, Moses Tar, Adam H. Kramer, Guillermo A. Villegas, Rabab A. Charafeddine, Olga Vafaeva, Parimala Nacharaju, Joel Friedman, Kelvin P. Davies, David J. Sharp
JCI Insight.2021;[Epub] CrossRef

Case Report

Burnt-out Metastatic Prostate Cancer.: Dong Suk Shin, Dong Hoe Koo, Suhyeon Yoo, Deok Yun Ju, Cheol Min Jang, Kwan Joong Joo, Hyun Chul Shin, Seoung Wan Chae; Yeungnam Univ J Med. 2013;30(2):116-119. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.116

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Abstract PDF: A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.

Original Article

Association between Obesity and Prostate Cancer.: Chang Jun Yoon, Ki Hak Moon, Tong Choon Park; Yeungnam Univ J Med. 2005;22(2):199-210. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.199

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Abstract PDF: BACKGROUND
The role of obesity in prostate cancer etiology remains controversial. The aim of this study was to evaluate the relationship between obesity and prostate cancer risk. MATERIALS AND METHODS: Between January 2000 and June 2005, 286 patients suspected of having prostate cancer underwent prostate biopsy. The clinical records of the 286 study patients were retrospectively reviewed with regard to age, Body Mass Index (BMI), serum PSA, TRUS, and prostate biopsy results. They were stratified by BMI into three groups according to the cutoffs recommended for Asian populations: normal, BMI less than 23 kg/m2; overweight, BMI 23 to 25 kg/m2; and obese, BMI greater than 25 kg/m2. RESULTS: As for BMIs, 132 (46.2%) were normal, 95 (33.2%) overweight and 59 (20.6%) were obese. A total of 99 (34.6%) patients were diagnosed as having prostate cancer. In multivariate logistic regression analyses, no significant association was observed between BMI and prostate cancer detection. CONCLUSION: We initially hypothesized that obesity may be biologically associated with increased prostate cancer development. However, our study did not show a significant association between BMI and prostate cancer.

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