Prostate Cancer: Diagnosis, Imaging, and Robotic Surgery

Full Article


Hong Kong J Radiol 2013;16(Suppl):S66-8

Prostate cancer is the third most common cancer affecting men in Hong Kong, and the fifth leading cause of cancer death in Hong Kong males. The diagnosis of prostate cancer is confirmed by biopsy. The cancer detection rate may be enhanced by judicious use of imaging studies and adopting an increased biopsy core protocol, particularly of the far lateral zone. Treatment of localised prostate cancer can range from active surveillance and irradiation to radical prostatectomy, depending on the patient and disease status. In terms of surgical treatment, robot-assisted laparoscopic radical prostatectomy represents one of the latest and most significant advances in minimally invasive surgery. Compared with open prostatectomy, this method is associated with significantly lower transfusion rates, faster patient recovery, and reduced hospital stay. For the surgeon, the advantages of this technique include improved vision and better instrument handling. It allows meticulous dissection of the prostate apex and neurovascular bundle so that sexual function may be preserved. Continence rates can be as high as 90% in patients who undergo this surgical procedure. In experienced hands, a positive surgical margin rate of less than 10% for localised disease can be achieved. Over the long term, robot-assisted laparoscopic radical prostatectomy has been associated with high rates of biochemical control. This article discusses the diagnosis of prostate cancer, with special focus on biopsy and surgical treatment with robot-assisted laparoscopic radical prostatectomy in the management of localised prostate cancer.