Radical prostatectomy for locally advanced primary or recurrent XXXX .

@entity1 @entity834 @entity5
AIM: Three papers including five @entity1 have described en bloc radical prostatectomy for locally advanced @entity5 . METHODS: Six @entity1 (median age 63 years) underwent en bloc radical prostatectomy for locally advanced (3) or recurrent (3) @entity5 involving the prostate. Quality of life questionnaires were answered postoperatively and the data prospectively entered in a database. RESULTS: One primary case had low anterior resection (LAR), the others abdominoperineal resections (APR) of R0 stage. Two recurrent cases had APRs and one @entity5 resection-all R1 stage. @entity834 led to construction of an ileal conduit in one @entity1 and in two healed on conservative treatment. Follow up was 10-50 months. One @entity1 died from distant metastases at 29 months postoperatively, one was operated for a single lung metastasis and one has disseminated lung metastases. None has developed local recurrence. Four of the five with anastomoses had good quality of life and none wanted an ileal conduit. CONCLUSION: In spite of a relatively high urinary leak rate the total complication rate seems to be lower than after pelvic exenteration. En bloc radical prostatectomy seems an option in selected @entity1 otherwise needing pelvic exenteration for locally advanced or recurrent @entity5 .
