Radical prostatectomy for low risk carcinoma of the prostate.

Department of Urologic Surgery, Vanderbilt University Medical Center, A 1302 Medical Center North, Nashville, TN, 37232-2765, USA. joseph.smith@vanderbilt.edu

OBJECTIVES: To review the role of radical prostatectomy in the management of patients with low risk carcinoma of the prostate. METHODS: A summary of personal experience and pertinent literature is provided. In particular, information which permits conclusions on the efficacy and side effects of radical prostatectomy in this situation is considered. RESULTS: For patients with low risk carcinoma of the prostate who choose to undergo treatment with curative intent, radical prostatectomy is an excellent option. Removal of the prostate with negative surgical margins can be achieved with a high frequency. Patients are afforded these curity of an undetectable PSA postoperatively which helps eliminate some of the inherent concerns which go along with an untreated or inadequately treated tumor. Recent modifications in surgical approach, including laparoscopic and robotic-assisted surgery, have lessened even further the impact of surgery on quality of life. CONCLUSION: Some patients with low risk disease who undergo radical prostatectomy are over treated and cured of a cancer which may not have been a significant threat to life or health. However, the uncertainty of active surveillance leads many patients to pursue curative therapy and radical prostatectomy offers an extremely low risk of death from prostate cancer, even with long term follow-up. Erectile dysfunction remains a potential quality of life compromise for some patients but, otherwise, the overwhelming majority return to their preoperative status within a short time with minimal risk for quality of life compromise.

PMID: 18594827 [PubMed - indexed for MEDLINE]