Factors associated with failure of retropubic radical prostatectomy

Abstract

Introduction: The failure of radical prostatectomy is defined as a biochemical recurrence or the absence of a decrease in PSAT to undetectable values 4-6 weeks after radical prostatectomy.

Objective: To evaluate the failures of radical prostatectomy in two urology departments in Dakar and to identify the contributing factors.

Patients and method: All patients who underwent an open retropubic radical prostatectomy and in whom there was a re-ascent of the total PSA to detectable values or an absence of a decrease in the total PSA to undetectable values were included.

Results: The study involved 111 patients. Thirty-one (31) patients were not included due to missing data from their records. The average age was 63.3±6.7 years. Most patients (70%) had cancer with high risk of recurrence according to the D’Amico classification. Failures were observed in 31 patients (27.9%). The time to onset was less than 2 years in 19 patients (17.1%). The status of the margins was specified in 78 patients (70.1%), the resection margins were positive in 33 patients (29.7%). The median disease-free survival was 4 years.

Conclusion: The analysis of our series revealed a high rate of recidivism. Thus, we propose a better management of patients with a high risk of recurrence.