Survival, Continence and Potency (SCP) recovery after radical retropubic prostatectomy: a long-term combined evaluation of surgical outcomes

Eur J Surg Oncol. 2014 Dec;40(12):1716-23. doi: 10.1016/j.ejso.2014.06.015. Epub 2014 Jul 18.

Abstract

Objective: To offer a comprehensive account of surgical outcomes on a defined series of patients treated with radical retropubic prostatectomy (RRP) for prostate cancer in a single European Center after 5-year minimum follow-up according to the Survival, Continence and Potency (SCP) system.

Material and methods: We evaluated our Institutional database of patients who underwent RRP from November 1995 to September 2008. Oncological and functional outcomes were reported according to the recently proposed SCP system.

Results: The 5- and 10-year biochemical recurrence-free survival rates were 80.1% and 55.8%, respectively. At the end of follow-up, 611 (78.5%) patients were fully continent (C0), 107 (13.8%) used 1 pad for security (C1) and 60 (7.7%) patients were incontinent (C2). Of the 112 patients who underwent nerve-sparing RRP, 22 (19.6%) were fully potent without aids (P0), 13 (11.6%) were potent with assumption of PDE-5 inhibitors (P1) and 77 (68.8%) experienced erectile dysfunction (P2). The combined SCP outcomes were reported together only in 95 (12.2%) evaluable patients. In patients preoperatively continent and potent, who received a nerve-sparing and did not require adjuvant therapy, oncological and functional success was attained by 29 (30.5%) patients. In the subgroup of 508 patients not evaluable for potency recovery, oncological and continence outcomes were obtained in 357 patients (70.3%).

Conclusion: Survival, Continence and Potency (SCP) classification offer a comprehensive report of surgical results, even in those patients who do not represent the best category, thus allowing to provide a much more accurate evaluation of outcomes after RP.

Keywords: Erectile function; Oncological outcomes; Prostate cancer; Radical retropubic prostatectomy; Urinary continence.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Erectile Dysfunction / epidemiology*
  • Erectile Dysfunction / etiology
  • Humans
  • Italy / epidemiology
  • Kaplan-Meier Estimate
  • Male
  • Prostatectomy / adverse effects*
  • Prostatectomy / methods*
  • Prostatic Neoplasms / mortality*
  • Prostatic Neoplasms / surgery*
  • Retrospective Studies
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Urinary Incontinence / epidemiology*
  • Urinary Incontinence / etiology