Initial Experience with Radical Prostatectomy Following Holmium Laser Enucleation of the Prostate.

Détails

ID Serval
serval:BIB_28F50CBA6159
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Initial Experience with Radical Prostatectomy Following Holmium Laser Enucleation of the Prostate.
Périodique
European urology focus
Auteur⸱e⸱s
Kretschmer A., Mazzone E., Barletta F., Leni R., Heidegger I., Tsaur I., van den Bergh RCN, Valerio M., Marra G., Kasivisvanathan V., Buchner A., Stief C.G., Briganti A., Montorsi F., Tilki D., Gandaglia G.
Collaborateur⸱rice⸱s
EAU-YAU Prostate Cancer Working Party
ISSN
2405-4569 (Electronic)
ISSN-L
2405-4569
Statut éditorial
Publié
Date de publication
11/2021
Peer-reviewed
Oui
Volume
7
Numéro
6
Pages
1247-1253
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Although an increasing number of prostate cancer (PCa) patients received holmium laser enucleation of the prostate (HoLEP) previously for benign prostatic obstruction (BPO), there is still no evidence regarding the outcomes of radical prostatectomy (RP) in this setting.
To assess functional and oncological results of RP in PCa patients who received HoLEP for BPO previously in a contemporary multi-institutional cohort.
A total of 95 patients who underwent RP between 2011 and 2019 and had a history of HoLEP were identified in two institutions. Functional as well as oncological follow-up was prospectively assessed and retrospectively analyzed.
RP following HoLEP compared with RP without previous transurethral surgery.
Patients with complete follow-up data were matched with individuals with no history of BPO surgery using propensity score matching. Complications were assessed using the Clavien-Dindo scale.
The median follow-up was 50.5 mo. We found no significant impact of previous HoLEP on positive surgical margin rate (14.0% [HoLEP] vs 18.8% [no HoLEP], p = 0.06) and biochemical recurrence-free survival (hazard ratio 0.74, 95% confidence interval [CI] 0.32-1.70, p = 0.4). Patients with a history of HoLEP had increased 1-yr urinary incontinence rates after RP. After adjusting for confounders, no significant impact of previous HoLEP was found (odds ratio [OR] 0.87, 95% CI 0.74-1.01; p = 0.07). Previous HoLEP did not hamper 1-yr erectile function recovery (OR 1.22, 95% CI 1.05-1.43; p = 0.01). Limitations include retrospective design and small sample size.
RP after previous HoLEP is surgically feasible, with low complication rates and no negative impact on biochemical recurrence-free survival. However, in a multivariable analysis, we observed significantly worse 1-yr continence rates in patients after previous HoLEP.
In the current study, we assessed the oncological and functional outcomes of radical prostatectomy in patients who underwent holmium laser enucleation of the prostate (HoLEP) previously due to prostatic bladder outlet obstruction. A history of HoLEP did not hamper oncological results, 1-yr continence, and erectile function recovery.
Mots-clé
Holmium laser enucleation of the prostate, Localized prostate cancer, Patient-reported outcomes, Radical prostatectomy, Urinary continence
Pubmed
Web of science
Création de la notice
26/09/2020 15:20
Dernière modification de la notice
08/01/2022 6:33
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