South Mersey Cancer Network

1
Radical Prostatectomy Sept 2008 till Aug 2009

• South Mersey Cancer Network

2
Radical Prostatectomy

• 36 patients
• 50 to 72 yrs (61 yrs)
• 28 open (12/16)
• 8 laparoscopic (no conversions)
• 52 to 71 yrs (61 yrs)

3
Pre op PSA

• 3.72 to 20.3ng/ml
• Average 8.2ng/ml
• Lap RP
• 6.4 to 11.4 ng/ml (8.47ng/ml)

4
Pre op Staging

• T1c 14 (3/8 lap)
• T2 20 (4/8 lap)
• T3a 1
• T4a 1 (1/8 lap)

5
Pre op Gleason Score

• 33 9/36
• 34 13/36
• 43 3/36
• 44 8/36
• 45 2/36

6
Complex Procedures

• 2007-08 32
• 2008-09 52

7
OP Time

• All patients
• 135 to 300 min (192 min)
• Open RRP
• 135 to 300 min (183 min)
• Lap RP
• 185 to 265 min (221 min)

8
Procedure

• Pelvic lymphadenectomy
• 20/36 (5/8 lap)
• Nerve sparing
• 16/24 (8/8 lap)

9
Blood Loss

• 100 ml to 4500 ml (1679 ml)
• Open RRP
• 1200 ml to 4500 ml (2300ml)
• Data was not recorded for 8 patients
• Lap RP
• 100 to 300 ml (193ml)
• Blood transfusion
• 7/36 pts (19)

10
Complications

• Bleeding requiring transfusion
• 7 patients
• One patient had a ureteric stent placed intra op

11
Length of Stay

• Range 2-10 days
• Mean 5.2 days
• Open prostatectomy
• 5.96 days
• Lap prostates 2-3 days
• 2.63 days

12
Post op

• Gleason Score
• 33 1/36
• 34 16/36
• 43 14/36
• 44 2/36
• 45 2/36
• 55 1/36

• PSA
• 25/30 are lt0.1ng/ml at 6 wks
• Lap prostate
• 4/5 patients with PSA lt0.1ng/ml

13
Positive Surgical Margins

• Overall 13/36 (36)
• Open
• RNS 3/16 (18)
• CSP 8/12 (66)
• 6/12 patients had pT3a disease
• Laparoscopic prostatectomy
• 2/8 (25)

14
Continence

• 28 patients with gt 3 mths follow up
• One (3.5) 3 pads a day
• 4 are wearing one pad a day
• 82 are pad free at 3 mths
• Lap prostatectomy
• 4 patients were dry immediately following TWOC
• 1 patient is wearing 3 pads/ day at 6 wks.