Published online Oct 31, 2008.
https://doi.org/10.4111/kju.2008.49.10.886
Comparison of Open versus Robotic Radical Prostatectomy in Clinically Advanced Prostate Cancer
Abstract
Purpose
To evaluate the outcomes of robotic prostatectomy (RP) compared with open radical prostatectomy (OP) in clinically advanced prostate cancer (PC).
Materials and Methods
Between January 2003 and June 2007 we performed radical prostatectomy in 180 patients with clinically advanced PC (OP, 88; RP, 92). We compared the perioperative parameters and early surgical outcomes between the OP and RP groups in patients with and without neoadjuvant hormonal therapy (NHT).
Results
In patients without NHT, there were no significant differences in preoperative characteristics between the OP and RP groups, but in patients with NHT, the RP patients had higher biopsy Gleason scores (GS) and clinical stages. There were no significant differences in lymph node (LN) invasion and extracapsular extension (ECE), but a significant difference existed in the prostatectomy GS between the OP and RP groups, regardless of NHT. The positive surgical margin rates in the RP group were similar to or lower than in the OP groups when stratified by pathologic stages T2 and T3. Irrespective of NHT, in the RP group the mean estimated blood loss was decreased, the mean duration of the hospital stay was less, and the length of bladder catheterization was shorter, but there were no significant differences in the postoperative day the regular diet was started or the frequency of complications. Although there were no significant differences in continence rates between the two groups, all the RP patients had a higher continence rate from 1 month postoperatively, with or without NHT.
Conclusions
Our results suggest that RP may be performed safely and may have results comparable to OP in clinically advanced PC.
Table 1
Preoperative patient characteristics
Table 2
Intraoperative and perioperative parameters based on the operative methods
Table 3
Complications based on the operative methods
Table 4
Return of continence based on the operative methods
References
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Montie JE. Initial therapy with radical prostatectomy for high risk localized prostate cancer. J Urol 2006;176:9.
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Song KH, Park H, Han JY, You CH, Ahn H, Kim CS. The effect of neoadjuvant hormonal treatment in prostate cancer on biochemical recurrence. Korean J Urol 2007;48:1125–1130.
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