Comparison of Treatment Outcomes between Laparoscopic and Robot-Assisted Laparoscopic Radical Prostatectomy in Clinically Localized Prostate Cancer, A Single-Surgeon Experience

2020 ◽  
Vol 103 (12) ◽  
pp. 1300-1308
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Laparoscopic Radical Prostatectomy ◽  
Localized Prostate Cancer ◽  
Robot Assisted ◽  
Oncological Outcomes ◽  
Estimated Blood Loss ◽  
Surgeon Experience ◽  
Potency Rate

Objective: To compare the treatment outcomes between laparoscopic radical prostatectomy (LRP) and robot-assisted laparoscopic radical prostatectomy (RALP) in clinically localized prostate cancer in a tertiary care hospital in Thailand by a single-surgeon experience. Materials and Methods: Between January 2013 and June 2019, 171 patients with clinically localized prostate cancer underwent minimally invasive radical prostatectomy. These were LRP in 62 patients and RALP in 109 patients. All clinical data were retrospectively reviewed. Patient demographic data, perioperative parameters, pathological reports, oncological outcomes, and functional outcomes including continence and potency rate at 1, 3, 6, and 12 months were compared between groups. Results: Patients in the RALP group were significantly younger (p=0.03) and had a shorter follow-up period (p=0.004). The estimated blood loss was significantly lower in the RALP group (p=0.001). There were no significant differences in intraoperative and 30-day postoperative complications. Pathological results and overall positive surgical margin rate (PSM) were not significantly different. In pT3 patients, PSM was significantly lower in the RALP group (p=0.045). Oncological outcomes were not different in term of biochemical recurrence (BCR) rate (p=0.3), median time to BCR (p=0.45), BCR-free survival (p=0.81), and overall survival (p=0.99). The continence rate was significantly better in the RALP group in every period after surgery (p=0.01, <0.001, 0.001, and p=0.02 at 1, 3, 6 and 12 months, respectively). The potency rate who performed bilateral neurovascular bundles sparing was not different between groups. Conclusion: RALP provided a significant improvement of continence recovery and PSM rate in non-organ confined disease. Estimated blood loss was significantly lower among the RALP patient. Larger numbers of patients with longer follow-up will justify proofing these findings. Keywords: Laparoscopic surgery, Robot-assisted surgery, Radical prostatectomy, Prostate cancer

scholarly journals Robot-Assisted vs. Laparoscopic Radical Prostatectomy for Immediate- and High-Risk Localized Prostate Cancer: A Propensity-Score Matched Analysis

2021 ◽  
Author(s):  
Deng Wen ◽  
Zhang Cheng ◽  
Jiang Hao ◽  
Li Yulei ◽  
Liu Xiaoqiang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Propensity Score ◽  
Lower Risk ◽  
Laparoscopic Radical Prostatectomy ◽  
Localized Prostate Cancer ◽  
Robot Assisted ◽  
Grade Ii

Abstract Background To evaluate the functional and oncological efficacy of robot-assisted radical prostatectomy (RARP) and laparoscopic radical prostatectomy (LRP) for immediate- and high-risk localized prostate cancer (PCa). Methods 232 patients bearing immediate- and high-risk localized PCa between January 2016 and October 2019 were enrolled according to the inclusion criteria. The perioperative, functional and oncological outcomes were compared between the RARP and LRP groups after applying the propensity-score matching (PM) (1:1) method, which were employed to attenuate the impact of the potential baseline confounders. Results In all, except for 10 patients without a suitable pair, the remaining patients in the LRP group were successfully matched to 85 patients in the RARP arm. All differences in preoperative variables turned to be insignificant after PM. Within the matched cohort, no open conversion was required in both groups. The RARP group was corrected with a significantly shorter mean operative time than the LRP group (p < 0.001). Patients in the RARP arm were also at a lower risk of ≤ Grade II complications than those in the LRP group (p = 0.036). Meanwhile, the proportions of transfusion and ≥ Grade II complications in the RARP group were similar to that in the LRP group (p = 0.192 and p = 1.000, respectively). No significant differences regarding the mean estimated blood loss, rates of pT3 disease and positive surgical margin, median specimen Gleason score and hospital stay length existed between the two groups. RARP vs. LRP tended to a significantly higher percentage of urinary continence at the removal of catheter (p = 0.031), postoperative 6 months (p = 0.043), and last follow-up (p = 0.046). Significant differences were also found between the RARP and LRP arms in erectile function at postoperative 6 months and last follow-up (p = 0.013 and p = 0.009, respectively). The statistical comparability between the two groups was observed in biochemical recurrence-free survival (p = 0.228). Conclusions For surgically managing immediate- and high-risk localized PCa, RARP tended to a lower risk of ≤ Grade II complications and superior functional preservation without cancer control being compromised when comparing with LRP.

scholarly journals Transvesical Versus Posterior Approach to Retzius-Sparing Robot-Assisted Radical Prostatectomy: A Retrospective Comparison With a 12-Month Follow-Up

2021 ◽  
Vol 11 ◽  
Author(s):  
Wen Deng ◽  
Cheng Zhang ◽  
Hao Jiang ◽  
Yulei Li ◽  
Ke Zhu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Erectile Function ◽  
Localized Prostate Cancer ◽  
Robot Assisted ◽  
Open Conversion ◽  
Estimated Blood Loss ◽  
Before And After ◽  
Grade Ii

ObjectivesTo assess the perioperative, functional, and oncological outcomes of transvesical robot-assisted radical prostatectomy (T-RARP) and posterior robot-assisted radical prostatectomy (P-RARP) for localized prostate cancer.Materials and MethodsWe analyzed the data of 96 patients who underwent T-RARP or P-RARP for localized prostate cancer between January 2017 and June 2019 in a retrospective fashion.ResultsNo significant differences in the baseline characteristics existed between the T-RARP and P-RARP arms. Both interventions were successfully performed without open conversion in either group. T-RARP was associated with a slightly more operative time (135.3 vs. 127.3 min) and estimated blood loss (105.2 vs. 94.2 mL) than P-RARP, but the differences were not significant (both p &gt; 0.05). The likelihood of transfusion, ≤Grade II, and &gt;Grade II postoperative complications, pT3a disease and positive surgical margins in the T-RARP group was comparable with that in the P-RARP group. No significant differences were noted between these two arms in terms of UC at the removal of catheter and nocturia (p = 0.750 and p = 0.684, respectively), and all included patients recovered UC at 3 months postoperatively. The median International Index of Erectile Function-5 score in both groups remains comparable before and after RARP. The patients in the T-RARP and P-RARP groups had a similar biochemical recurrence-free survival (p = 0.387).ConclusionsBoth T-RARP and P-RARP by experienced hands are feasible for well-selected patients with prostate cancer, obtaining similar outcomes in terms of perioperative results, UC and erectile function, and oncological control within short-term follow-up.

Effect of open versus robot-assisted laparoscopic radical prostatectomy on cancer control in patients with clinically localized prostate cancer: Prospective analysis of 1,014 consecutive patients.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 80-80
Author(s):  
Adrian Stuart Fairey ◽  
Niels Jacobsen ◽  
Don Voaklander ◽  
Eric Estey
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Surgical Approach ◽  
Biochemical Recurrence ◽  
Cancer Control ◽  
Laparoscopic Radical Prostatectomy ◽  
Localized Prostate Cancer ◽  
Prospective Analysis ◽  
Robot Assisted

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.

scholarly journals Comparison of functional and oncological outcomes of innovative “three-port” and traditional “four-port” laparoscopic radical prostatectomy in patients with prostate cancer

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ben Xu ◽  
Si-da Cheng ◽  
Yi-ji Peng ◽  
Qian Zhang
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Laparoscopic Radical Prostatectomy ◽  
Positive Surgical Margin ◽  
Oncological Outcomes ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background To compare the functional and oncological outcomes between innovative “three-port” and traditional “four-port” laparoscopic radical prostatectomy (LRP) in patients with prostate cancer (PCa). Methods We retrospectively collected the data of PCa patients treated at our institutions from June 2012 to May 2016. According to the inclusion criteria, a total of 234 patients were included in the study, including 112 in group A (four-port) and 122 in group B (three-port). The perioperatively surgical characteristics, functional and oncological outcomes were compared between groups. Results There were no statistical differences in the baseline parameters between these two groups. Compared with group A, the operative time (OT) and estimated blood loss (EBL) were significantly less in group B. On follow-up, the rate of positive surgical margin (PSM), prostate specific antigen (PSA) biochemical recurrence and continence after LRP did not show any statistically significant difference between the groups. An identical conclusion was also received in comparison of overall survival (OS) and biochemical recurrence-free survival (BRFS) between both groups. Conclusions Innovative “three-port” LRP can significantly shorten the OT and reduce the EBL compared with the traditional “four-port” LRP. Meanwhile, it does not increase the rate of PSM and PSA biochemical recurrence. “Three-port” LRP could be popularized in the future in view of its superior surgical technique, considerably better functional outcomes and remarkable oncological control.

Long-Term Oncologic Outcome of an Initial Series of Laparoscopic Radical Prostatectomy for Clinically Localized Prostate Cancer After a Median Follow-up of 10 Years

2016 ◽  
Vol 14 (4) ◽  
pp. 290-297 ◽  
Author(s):  
Ashkan Mortezavi ◽  
Tullio Sulser ◽  
Jacopo Robbiani ◽  
Eva Drescher ◽  
Daniel Disteldorf ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Oncologic Outcome ◽  
Laparoscopic Radical Prostatectomy ◽  
Localized Prostate Cancer ◽  
Initial Series

Influence of pathological factors on oncological outcomes after robot-assisted radical prostatectomy for localized prostate cancer: Results of a prospective study

2015 ◽  
Vol 33 (7) ◽  
pp. 330.e1-330.e7 ◽  
Author(s):  
Sébastien Kozal ◽  
Benoit Peyronnet ◽  
Susanna Cattarino ◽  
Thomas Seisen ◽  
Eva Comperat ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Prospective Study ◽  
Localized Prostate Cancer ◽  
Robot Assisted ◽  
Oncological Outcomes ◽  
A Prospective Study
Sign in / Sign up

Export Citation Format

Share Document