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What's known on the subject? and What does the study add? Laparoscopic radical prostatectomy ( LRP) has shown good oncological short-term and mid-term outcomes, but long-term outcomes are still lacking., We present long-term oncological outcomes of LRP in a large cohort of patients operated on in one of the pioneering European centres. The data from the present study show high rates of biochemical and clinical recurrence-free survival and low cancer-specific mortality compared with open series., Objectives To investigate long-term oncological outcomes after laparoscopic radical prostatectomy ( LRP)., To identify parameters influencing recurrence-free survival in a single-institution series., Patients and Methods All patients underwent LRP using the transperitoneal retrograde Heilbronn technique. High-risk patients received adjuvant treatment according to an institutional algorithm based on prostate-specific antigen ( PSA), Gleason score, tumour-node-metastasis stage, margin status and tumour volume., Data were collected prospectively on operative and postoperative parameters beginning in 1999. Complete follow-up data of 370 of the first 500 consecutive patients are available., Biochemical recurrence was defined as two consecutive PSA levels <0.2 ng/mL within the follow-up period., Kaplan- Meier estimates and Cox regression were applied to examine recurrence-free survival times., Results The estimated biochemical recurrence-free survival ( BCRFS) rates 10 years after LRP were 80.2% in patients staged pT2, 47.4% in those staged pT3a and 49.8% in those staged pT3b/4, confirming a better prognosis in patients with organ-confined disease ( P < 0.001)., In the multivariate Cox regression analysis, only Gleason score and pT stage significantly influenced BCRFS., The 10-year clinical progression-free survival rates were 97.2% ( pT2), 84.4% ( pT3a) and 78.1% ( pT3b/4), and prostate cancer-specific survival estimates were 100% ( pT2), 97.3% ( pT3a) and 90.6% ( pT3b/4)., Conclusions The 10-year biochemical and clinical progression-free survival after LRP combined with a risk-adapted concept of adjuvant therapy is high, while prostate-cancer specific mortality is low. Our data shows no negative impact of laparoscopic techniques on oncologic outcomes compared to large series after retropubic radical prostatectomy., In a multivariate Cox regression, only Gleason score and pT stage had significant impact on BCRFS. [ABSTRACT FROM AUTHOR]