Comparative analysis of the oncological outcomes after retropubic and robot-assisted radical prostatectomy in patients with localized prostate cancer

Rasner P.I., Kotenko D.V., Pushkar' D.Yu.

Radical prostatectomy is a main treatment modality for the patients with localized prostate cancer. We have performed a comparative retrospective evaluation of the outcomes for robot-assisted (RALP) and open retropubic radical prostatectomies (RPE) concerning the overall and cancer-specific survival and biochemical recurrence.

Materials and methods. Two groups were included in this study. The first group consisted of 512 patients with RALP. The second group consisted of 71 patients with RPE. All operations were done on in urological clinic of MSMSU in a period from 2008 to 2013. Median follow-up was 38.9 max for RALP (max 63.9 months) group and 22.6 months (max 46) in RPE group. Groups were comparable with regard to age, comorbidities and oncological characteristics.

Results. Postoperative pathological stage distribution was similar in groups. Pelvic lymphadenectomy was carried out in approximately one third of patients in both groups. pN1 stage was detected at the level of 1%. Extraprostatic extension of the tumor was detected in 25.4% of RALP patients and 35.2% of RPE patients. Seminal vesicle invasion was evident in 10.8% and 9.9% of patients in RALP and RPE groups, correspondingly.

Biochemical recurrence developed in 21.9% of RALP patients and 15.9% of RPE patients, with the difference according to the KaplanMeyer analysis being statistically insignificant. Overall survival at the last follow-up round was 98.2% for RALP and 98.6% for RPE with the cancer-specific survival 100% in both groups.

Conclusion. Based on survival analysis, retropubic and robot-assisted radical prostatectomies provide durable and excellent oncological results.

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