OBJECTIVES: To compare oncological outcomes of a consecutive retropubic radical prostatectomy (RRP) and robot-assisted radical prostatectomy (RARP) series performed by a single surgeon who had performed >750 prior RRPs and was starting to perform RARPs. MATERIALS AND METHODS: Prospectively collected longitudinal data of 277 RRP and 730 RARP cases over a 5-year period were retrospectively analyzed. The RARP series were divided into 3 subgroups (1st, <250 cases; 2nd, 250-500; and 3rd, >500) according to the surgical period. The positive surgical margin (PSM) and biochemical recurrence-free survival (BCRFS) rates were compared at each pathological stage. RESULTS: The pT2 PSM rates showed no significant difference between the RRP (7.8%) and RARP series (1st, 9.5%; 2nd, 14.1%; and 3rd, 9.8%) throughout the study period (P = 0.689, 0.079, and 0.688, respectively). Although the pT3 PSM rates of the 1st (50.6%) and 2nd RARP series (50.0%) were higher than that of the RRP series (36.0%; P = 0.044 and P = 0.069, respectively), the 3rd RARP series had a comparable pT3 PSM rate (32.4%, P = 0.641). The 3-year BCRFS rates of the RRP and RARP series were similar at each pathological stage (pT2, 92.1 vs. 96.8%, P = 0.517; pT3, 60.0 vs. 67.3%, P = 0.265, respectively). CONCLUSIONS: The pT2 PSM and short-term BCRFS rates were similar between RRP and RARP, and RARP showed comparable pT3 PSM rate with RRP after >500 cases of surgical experience. Our data suggest that an experienced robotic surgeon at a high-volume center may achieve comparable oncological outcomes with open prostatectomy even in locally advanced disease.
OBJECTIVES: To compare oncological outcomes of a consecutive retropubic radical prostatectomy (RRP) and robot-assisted radical prostatectomy (RARP) series performed by a single surgeon who had performed >750 prior RRPs and was starting to perform RARPs. MATERIALS AND METHODS: Prospectively collected longitudinal data of 277 RRP and 730 RARP cases over a 5-year period were retrospectively analyzed. The RARP series were divided into 3 subgroups (1st, <250 cases; 2nd, 250-500; and 3rd, >500) according to the surgical period. The positive surgical margin (PSM) and biochemical recurrence-free survival (BCRFS) rates were compared at each pathological stage. RESULTS: The pT2 PSM rates showed no significant difference between the RRP (7.8%) and RARP series (1st, 9.5%; 2nd, 14.1%; and 3rd, 9.8%) throughout the study period (P = 0.689, 0.079, and 0.688, respectively). Although the pT3 PSM rates of the 1st (50.6%) and 2nd RARP series (50.0%) were higher than that of the RRP series (36.0%; P = 0.044 and P = 0.069, respectively), the 3rd RARP series had a comparable pT3 PSM rate (32.4%, P = 0.641). The 3-year BCRFS rates of the RRP and RARP series were similar at each pathological stage (pT2, 92.1 vs. 96.8%, P = 0.517; pT3, 60.0 vs. 67.3%, P = 0.265, respectively). CONCLUSIONS: The pT2 PSM and short-term BCRFS rates were similar between RRP and RARP, and RARP showed comparable pT3 PSM rate with RRP after >500 cases of surgical experience. Our data suggest that an experienced robotic surgeon at a high-volume center may achieve comparable oncological outcomes with open prostatectomy even in locally advanced disease.
Authors: Ashutosh Tewari; Prasanna Sooriakumaran; Daniel A Bloch; Usha Seshadri-Kreaden; April E Hebert; Peter Wiklund Journal: Eur Urol Date: 2012-02-24 Impact factor: 20.096
Authors: Giovanni B Di Pierro; Philipp Baumeister; Patrick Stucki; Josef Beatrice; Hansjörg Danuser; Agostino Mattei Journal: Eur Urol Date: 2010-10-21 Impact factor: 20.096
Authors: Daniel A Barocas; Shady Salem; Yakup Kordan; S Duke Herrell; Sam S Chang; Peter E Clark; Rodney Davis; Roxelyn Baumgartner; Sharon Phillips; Michael S Cookson; Joseph A Smith Journal: J Urol Date: 2010-01-18 Impact factor: 7.450
Authors: David B Samadi; Paul Muntner; Fatima Nabizada-Pace; Jonathan S Brajtbord; John Carlucci; Hugh J Lavery Journal: J Endourol Date: 2010-07 Impact factor: 2.942
Authors: Kevin C Zorn; Ofer N Gofrit; Marcelo A Orvieto; Albert A Mikhail; Gregory P Zagaja; Arieh L Shalhav Journal: Eur Urol Date: 2006-10-27 Impact factor: 20.096
Authors: Sanoj Punnen; Maxwell V Meng; Matthew R Cooperberg; Kirsten L Greene; Janet E Cowan; Peter R Carroll Journal: BJU Int Date: 2013-03-04 Impact factor: 5.588
Authors: Kevin C Zorn; Mark A Wille; Alan E Thong; Mark H Katz; Sergey A Shikanov; Aria Razmaria; Ofer N Gofrit; Gregory P Zagaja; Arieh L Shalhav Journal: Can J Urol Date: 2009-08 Impact factor: 1.344
Authors: Georgios Hatzichristodoulou; Stefan Wagenpfeil; Gregor Weirich; Michael Autenrieth; Tobias Maurer; Mark Thalgott; Thomas Horn; Matthias Heck; Kathleen Herkommer; Jürgen E Gschwend; Hubert Kübler Journal: World J Urol Date: 2015-06-23 Impact factor: 4.226
Authors: Georgios Hatzichristodoulou; Stefan Wagenpfeil; Gudrun Wagenpfeil; Tobias Maurer; Thomas Horn; Kathleen Herkommer; Marie Hegemann; Jürgen E Gschwend; Hubert Kübler Journal: World J Urol Date: 2015-09-29 Impact factor: 4.226