关键词: 腹腔镜下根治性前列腺切除术, 肿瘤学和功能学结局, 术后临床治愈, 尿失禁, 勃起功能障碍

Abstract: Objective To assess long-term urinary control function, sexual function and disease recurrence, overall mortality, and risk of death from prostate cancer after laparoscopic radical prostatectomy(LRP). Methods Oncologic outcomes and functional outcomes were analyzed retrospectively in 99 patients who underwent LRP from June 2009 to December 2013.  Finally 80 patients were included in the study according to the exclusion criteria. Cox regression was used to analyze the risk factors for overall survival(OS), cancer-specific survival(CSS), and radiologic progression-free survival(rPFS) after LRP. Results The 5-year and 10-year OS rates after LRP were 86% and 70%, the CSS rates were 91% and 85%, and PFS rates were 87% and 76%, respectively. Pathological Gleason score and failure to achieve clinical cure after surgery were independent risk factors for OS, pathological Gleason score was an independent risk factor for CSS, and the highest preoperative prostate specific antigen (PSA) level > 20 ng/mL was an independent risk factor for PFS, but failure to achieve clinical cure after surgery had a marginal significance on CSS and PFS. The rate of urinary continence was 76.8%, 21.4% had urinary incontinence to varing degree, 51.8% had no sexual stimulation or arousal, 12.5% had normal sexual activity, and 35.7% had erectile dysfunction insufficient to maintain normal sexual activity, and the incidence of erectile dysfunction was higher in patients without preserving vascular nerve bundles than  those with preservation during LRP. Conclusion The 10-year long-term outcomes of oncology and urinary continence after LRP are similar to the previous reports, LRP is an optimal option to achieve satisfactory oncological and functional outcomes for patients with prostate cancer. 

Key words: laparoscopic radical prostatectomy, oncologic and functional outcomes, clinical cure, urinary incontinence, erectile dysfunction