[Early results following radical prostatectomy in patients with capsule invasion, seminal vesicle infiltration and micrometastases]

Abstract

One hundred thirty-three patients with prostatic carcinoma underwent bilateral pelvic lymphadenectomy and radical retropubic prostatectomy between 1975 and 1988. Patients who had a localized prostatic carcinoma (less than or equal to T2b N0 M0 or less than or equal to B 2) and a small number (n = 10) with limited T3 carcinoma were considered for surgical therapy on the basis of a digital prostatic examination. Histological examination revealed locally advanced prostatic carcinoma in 89 patients with capsular infiltration or perforation and seminal vesicle involvement. Microscopic lymph node metastases were noted in 14 cases. Some patients with capsular perforation and seminal vesicle involvement received adjuvant therapy (orchiectomy or radiation). All patients with lymph node metastases were treated by orchiectomy. One local failure occurred among 24 patients with capsular infiltration within 42 months of follow-up. No failure occurred in stage pT3 disease (capsular perforation) with adjuvant therapy (n = 12) and in stage pT3 disease (seminal vesicle involvement) with (n = 9) and without (n = 12) adjuvant therapy after mean follow-up periods of 35, 42 and 52 months, respectively. Distant metastases occurred in 2 patients with stage pT3 disease (capsular perforation) without adjuvant therapy (n = 18) within a mean follow-up of 51 months, and 1 of these patients died of prostatic cancer. Distant metastases occurred in 3 patients with pT2-pT3N1 disease within a mean follow-up of 54 months: 1 of these patients died of prostatic cancer. Local failure was noted in 1 patient in this group.(ABSTRACT TRUNCATED AT 250 WORDS)