Urologists at the Mayo Clinic have presented new data on several subjects during the 2015 American Urological Association (AUA) Annual Meeting held recently in New Orleans, May 15 to 19. Data on topics like incontinence, obesity, bladder/bowel dysfunction in children and prostatectomy (surgical removal of the prostate gland) were presented.
One presentation entitled “Long-Term Patient-Reported Functional Outcomes Following Open, Laparoscopic and Robotic-Assisted Radical Prostatectomy Performed by High-Volume Surgeons” focused on the outcomes after radical prostatectomy. There are three types of prostatectomy that can be performed to remove prostate cancer: open surgery, laparoscopic surgery and robotic-assisted surgery.
The team analyzed data on self-reported surveys of 1,686 men who were submitted to one of the three types of radical prostatectomy at the Mayo Clinic or the Massachusetts General Hospital, between 2009 and 2012. Surveys were collected in average 30.5 months after surgery. Researchers reported that patients could basically expect similar results from all three types of surgery, including the risks associated to it, namely after-surgery urinary incontinence and sexual dysfunction.
“I think it reaffirms the point that it’s not necessarily the surgery that is being done but it’s more likely the surgeon that’s doing it,” said the study’s lead author Dr. Jeffrey Karnes in a news release. “The outcomes were independent of the technique, whether it was done robotic, laparoscopic or standard open. (…) It’s probably more important to have a high-volume surgeon that does one technique than a low-volume surgeon that’s just starting in that technique. If you’re going to have somebody build a house, you’d probably want to know how many houses they’ve built rather than what kind of tools they have in their toolkit.”
Another presentation entitled “Very Long-Term Oncological Outcomes of Patients Treated with Radical Prostatectomy for Node-Positive Prostate Cancer: A Multi-Institutional, Conditional Survival Analysis” also focused on radical prostatectomy outcomes. According to the researchers, men who had their cancerous prostate and nodes surgically removed, often have better clinical outcomes and long-term survival rates.
Researchers at the Mayo Clinic and San Raffaele Hospital (Milan) assessed 1,947 men whose prostates had been removed with associated lymph node spread. The median follow-up of these cases was more than 14 years. The team found that in patients who experienced a biochemical recurrence after surgery, defined as a PSA (prostate-specific antigens) value greater than 0.2 ng/mL, the rates of remaining metastasis free (no cancer spread) for 10, 15 and 20 years were approximately 55%, 50% and 45%, respectively. On the other hand, patients without biochemical recurrence in the first 5, 10 or 15 years after surgery were not likely to die from the disease; however, follow-up and continued monitoring of PSA levels is essential because “your recurrence rate is never zero.” concluded study lead author Dr. Marco Moschini.
These results highlight the fact that surgeons’ experience in radical prostatectomy can have an impact on surgical clinical outcome and that prostate cancer patients without recurrence of up to 15 years after prostatectomy are not likely to succumb to the malignancy.