Experienced open vs early robotic-assisted laparoscopic radical prostatectomy: A 10-year prospective and retrospective comparison Journal Article


Authors: Jackson, M. A.; Bellas, N.; Siegrist, T.; Haddock, P.; Staff, I.; Laudone, V.; Wagner, J. R.
Article Title: Experienced open vs early robotic-assisted laparoscopic radical prostatectomy: A 10-year prospective and retrospective comparison
Abstract: Objective To undertake a prospective/retrospective comparison of longer-term oncologic and quality of life outcomes in open radical prostatectomy (ORP) or robotic-assisted laparoscopic radical prostatectomy (RALP) patients. Materials and Methods The clinical progression of ORP and RALP patients who underwent surgery during 2004 was followed over an extended (10 year) period. Pre- and perioperative parameters, oncologic outcomes, recurrence, mortality, and quality of life were compared between surgical modalities. Follow-up time was calculated from the time of surgery to the latest contact. Postoperative quality of life data were obtained from Expanded Prostate Cancer Index Composite survey questionnaires. Recurrence rates, times to recurrence, surgical time, length of stay, hematocrit, follow-up time, and sexual and urinary bother scores were compared between surgical groups. Multivariate analyses were used to predict positive surgical margins and biochemical recurrence. Results 63 ORP and 116 RALP patients were included (mean age of 60.4 ± 6.4 and 58.6 ± 5.8 years; P =.067), with follow-up times of 10.3 and 10.1 years (P =.191). RALP patients had longer operative times (P <.001), shorter hospital stays (P <.001), and higher discharge hematocrits (P <.001). With prostate-specific antigen, Gleason score, and T-stage as covariates, time to recurrence (P =.365) and positive margin rate (P =.230) were not statistically different between groups. Ninety-five percent of RALP patients were continent and 48.0% were potent vs 92.6% and 41.5% of ORP patients (P =.720;.497). Urinary and sexual bother were not significantly different between groups (P =.392;.985). Conclusion Our longer-term follow-up data suggest that ORP and RALP patients have comparable oncologic and quality of life outcomes. © 2016 Elsevier Inc.
Journal Title: Urology
Volume: 91
ISSN: 0090-4295
Publisher: Elsevier Science, Inc.  
Date Published: 2016-05-01
Start Page: 111
End Page: 116
Language: English
DOI: 10.1016/j.urology.2015.12.072
PROVIDER: scopus
PUBMED: 26879735
DOI/URL:
Notes: Article -- Export Date: 2 June 2016 -- Source: Scopus
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  1. Vincent Laudone
    59 Laudone