RADICAL PERINEAL PROSTATECTOMY WITHOUT PELVIC LYMPHADENECTOMY - SELECTION CRITERIA AND EARLY RESULTS

Purpose: We evaluated the surgical efficacy of radical perineal prosta tectomy and determined preoperative parameters to identify patients at low risk for nodal metastasis. Materials and Methods: Of 155 men eval uated for radical perineal prostatectomy, 74 were assigned to a low ri sk category (prostate specific antigen less than 10 ng./ml., Gleason s core less than 7). Of the patients 40 underwent laparoscopic lymph nod e dissection and 34 did not. This group was compared to 81 patients wh o underwent surgical staging and did not fit the low risk criteria. Re sults: None of 74 patients in the low risk group had nodal metastasis, while metastasis was present in 5 of 81 (6.1%) who did not meet such parameters. Organ-confined disease was present in 71.6% of men with lo w risk criteria, which was a significantly different rate than the 51. 9% found in the other 81 men. Conclusions: Radical perineal prostatect omy confers adequate cancer control and can be performed without pelvi c node dissection in select patients.