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/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. Post-operative quality of life data were obtained from EPIC-26 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=0. 067), with a follow-up time of 10. 3 and 10. 1 years (p=0. 191). RALP patients had longer operative times (p<0. 001), shorter hospital stays (p<0. 001), and higher discharge hematocrits (p<0. 001). With PSA, Gleason score and T-stage as covariates, time to recurrence (p=0. 365) and positive margin rate (p=0. 230) were not statistically different between groups. 95. 0% of RALP patients were continent and 48. 0% were potent vs. 92. 6% and 41. 5% of ORP patients (p=0. 720; 0. 497). Urinary and sexual bother were not significantly different between groups (p=0. 392; 0. 985).
CONCLUSIONS - Our longer-term follow-up data suggest that ORP and RALP patients have comparable oncologic and quality of life outcomes.
Urology. 2016 Feb 12 [Epub ahead of print]
Max A Jackson, Nicholas Bellas, Timothy Siegrist, Peter Haddock, Ilene Staff, Vincent Laudone, Joseph R Wagner
Urology Division, Hartford Hospital, Suite 416, 4th Floor, 85 Seymour Street, Hartford, CT, 06106, USA. , Urology Division, Hartford Hospital, Suite 416, 4th Floor, 85 Seymour Street, Hartford, CT, 06106, USA. , Urology Service, Middlesex Hospital, Middletown, CT, 06457, USA. , Urology Division, Hartford Hospital, Suite 416, 4th Floor, 85 Seymour Street, Hartford, CT, 06106, USA. Research Program, Hartford Hospital, Hartford, CT, 06106, USA. , Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. , Urology Division, Hartford Hospital, Suite 416, 4th Floor, 85 Seymour Street, Hartford, CT, 06106, USA.