Læknablaðið : fylgirit - 01.06.2009, Side 11

2 7 T H CONGR SCAND ASSOC UROL
F Y L G I R I T 6 1
patients were younger and more slim, selection criterias might
explain part of the difference. In the present study pre-, per-
and postoperative variables were tested against the rate of
incontinence.
Material: In total 133 patients were operated on during 2007,
- 40% with ROP and 60% with RRP.T category, PSA, Gleason
score, volume, nervesparing technique or not and surgeons
experience were registered from the departments prostate
cancer database. The reported incontinence rate is correlated
to each of these variables to describe selective differences when
choosing ROP or RRP.
Results: Total continence was reached for 88% and 72%
after ROP resp. RRP after one year. Patients who were major
incontinent had a leakage of 177 grams/24 hours (16-920) in the
RRP group and 26 grams/24 hours (24-28) in the ROP group.
Patients chosen for ROP had less tumour load and better short
time biochemical oncological outcome. Nervesparing technique
was used equally. ROP was performed by one experienced
surgeon in contrast to RRP which was performed by several
surgeons with different experience.
Conclusion: The shown benefit in morbidity favorable for ROP
could be explained as a difference in selection criterias.
Ref: Seyer-Hansen AD, Hvistendahl GM, Graugaard-Jensen
C, Pedersen KV, Skou S. Urinary continence after radical
prostatectomy - influence by the surgical method. Submitted for
NUF2009, nurse section.
08 Mortality rate after retropubic radical prostatectomy
HO Beisland1, E Servoll1, L Vlatkovic2, T Sæter1, G Waaler1
'Section ofUrology, Sorlandet Hospital, Arendal, and 2Department ofPathology,
Norwegian Radium Hospital, Oslo
hans.olav.beisland@sshf.no
Aim: To present the mortality rate after retropubic radical
prostatectomy at a Norwegian county hospital.
Material and methods: The material consists of 151 men
operated in the period October 1985 - June 2006. Median age
was 61 years (range 44-72). The observation time ranges 276
-14 months (median 80). Postoperatively the patients have been
seen regularly. The hospital files were reviewed in November
2008 to collect data for this study. The histological specimens
have recently been reinvestigated with regard to Gleason score
an tertiary Gleason pattem by an experienced uropathologist.
Results and discussion: There is no 30-days mortality. 22
patients have died in the follow up period, six from prostate
cancer (3.9%) 60-194 months postoperatively and 16 patients
from other reasons (10.5%) after 14-230 months. The six patients
who died from prostate cancer had all a high Gleason score.
Among the 16 patients who died from other reasons, a clinical
relapse occurred in seven and they had a rather high Gleason
score or high-graded tertiary Gleason. It is therefore not to
exclude that the prostate cancer may have been a part of the
cause of their death. If these seven patients are added to the six
who really died from prostate cancer, the total cancer specific
mortality will increase to 8.6%.
Conclusions: The mortality rate over a period of 23 years is
acceptable. It is possible to perform safe prostate cancer surgery
at county hospitals.
09 Tertiary Gleason pattern is a predictor of PSA-
relapse after radical prostatectomy
E Servoll1, L Vlatkovic2, T Sæter1, G Waaler1, HO Beisland1
'Sorlandet Hospital, Arendal and 2The Norwegian Radium Hospitai, Oslo,
Norway
einar.servoll@sshf.no
Aim: The Gleason score consists of a primary and a secondary
grade. However a tertiary pattern has been found in tumours.
In this study we examined the impact of tertiary Gleasonon
biochemical relapse rate in patients treated with RRR
Material and methods: Between 1985 and 2005, 151 men
underwent RRP at Sorlandet County Hospital, Arendal. None of
the patients had preoperative radiation or androgen deprivation
therapy. Clinical records were reviewed to determine patient's
characteristics and evidence of biochemical recurrence (PSA
^0.2 ng/ml).The microscopic examination of the RRP specimens
and Gleason grading was reassessed retrospectively by a single
uropathologist (LV), without the knowledge of clinical outcome.
Kaplan-Meier plots and Cox proportional hazards regression
were used in statistical analyses.
Results and discussion: 35 patients (23.6%) had a tertiary
Gleason grade 4 or 5. Biochemical relapse was observed in 67
patients (45.3%). 26 patients (74.3%) with a tertiary Gleason had
PSA relapse. In analyses controlling for preoperative PSA and
pathological T-stage, tertiary Gleason remained anindependent
predictor of biochemical failure (p= 0.012).
Conclusion: Tertiary Gleason is a predictor of biochemical
relapse in patients operated with RRP.
10 The oncological outcome and preoperative
prediction of pT3 prostate cancer patients
M Mortensen1, BP Ulhoi2, M Borre1
Department ofUrology1 and Pathology2, Aarhus University Hospital, Denmark
martinmortensen@hotmail.com
Aim: To evaluate surgical margin status and disease free sur-
vival rates in pT3 prostate cancer patients undergoing radical
prostatectomy (RP) at our institution.
Patients and materials: Data concerning 535 RP patients has
prospectively been collected for "the Aarhus PC-project".
Median follow-up was 48 (12-141) months. Recurrence of serum
PSA defined as > 0.2 ng/mL.
Results: The pT-classification demonstrates 162 (30 %) cases
of either extra capsular tumour extension (pT3a; n=104) or in-
volvement of the vesicular seminalis (pT3b; n=58).Totally 147
(28 %) specimens had tumour positive margins, of which 104
(71%) had pT3 origin (p<0.001). The disease free survival was in
highly statistically significant favour of patients suffering from
localized disease (pT2). The positive and negative predictive
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