MORBIDITY OF PELVIC LYMPHADENECTOMY, RADICAL RETROPUBIC PROSTATECTOMYAND EXTERNAL RADIOTHERAPY IN PATIENTS WITH LOCALIZED PROSTATIC-CANCER

Staging pelvic lymphadenectomy (PLND) was performed in 210 prostatic c ancer patients (mean age 67 years, clinical stage T0-T3 MO). A radical retropubic prostatectomy was subsequently performed in 54 men, ten of whom also received postoperative radiotherapy due to positive surgica l margins. Ninety-eight patients were treated with external beam radia tion alone (70 Gy in 35 fractions) and the remaining 58 received endoc rine therapy. The complications of PLND alone (156 patients), consiste d of wound infection in eight patients, hematoma or lymphocele in seve n, venous thrombosis in three, and cardiac infarction in one patient. Early side-effects of radiotherapy included mild to moderate proctitis and/or cystitis in 57 patients. One year after completion of therapy, 48 of the irradiated men had proctitis, but only six had severe sympt oms. Four patients developed radiation cystitis and two urethral stric ture. Following prostatectomy (54 patients), two patients died in pulm onary embolism and another one developed a deep venous thrombosis. Hem atoma occurred in five patients. Of the 42 surviving patients who did not receive postoperative radiotherapy, eight developed anastomotic st rictures and four had severe stress incontinence. Only five were fully potent one year after surgery. Eight of the ten patients receiving ra diotherapy after prostatectomy developed side-effects from the intesti ne and/or the urinary bladder. Two of them became totally incontinent. One developed a severe hemorrhagic cystitis necessitating urinary div ersion. All ten were impotent after treatment.