80 Background: There are limited prospective data comparing outcomes of Open Radical Prostatectomy (ORP) and Robot-Assisted Laparoscopic Radical Prostatectomy (RALRP) for clinically localized prostate cancer. Our aim was to compare ORP and RALRP with respect to cancer control outcomes. Methods: A prospective analysis of data from the University of Alberta Radical Prostatectomy Database was performed. Between September 2007 and August 2010, 1019 consecutive men underwent radical prostatectomy for clinically localized prostate cancer. The surgical approach was selected by the surgeon. The outcomes were biochemical recurrence (BCR) and positive surgical margins (PSM). BCR was defined as a PSA ≥ 0.1 ng/ml followed by a subsequent confirmatory value or initiation of salvage therapy. PSM was defined as the presence of cancer at the inked margin in the radical prostatectomy specimen. The Kaplan-Meier method was used to estimate biochemical recurrence free survival (BCRFS). Univariable and multivariable analyses were used to determine the association between surgical approach and outcomes. Results: Data were evaluable for 1014 out of 1019 patients. 204 patients underwent ORP and 810 patients underwent RALRP. The median follow-up duration was 21 months (IQR 12 to 29). Baseline characteristics were similar between the groups. In univariable analysis, 3-year BCRFS (90.6% versus 88.9%), overall PSM (26.5% versus 28.8%), and stage-stratified PSM (pT2: 19.9% versus 21.8%; pT3: 40.6% versus 49.1%) did not differ between the groups (all comparisons p>0.05). In multivariable analysis, surgical approach was not independently associated with BCR (HR 0.77, 95% CI 0.43 to 1.37, p=0.37) or PSM (OR 1.2, 95% CI 0.80 to 1.67, p=0.44). Conclusions: ORP and RALRP provided comparable short-term oncologic efficacy. Extended follow-up of the prospective cohort is needed to confirm these preliminary findings.
