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Mid-term biochemical recurrence-free outcomes following robotic versus laparoscopic radical prostatectomy

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Abstract

We compared 5-year biochemical recurrence (BCR)-free rates for robotic-assisted laparoscopic prostatectomy (RALP) and laparoscopic radical prostatectomy (LRP). Three hundred and twelve consecutive patients who underwent RALP from 2003 to 2008 were compared to 97 consecutive LRP patients from 1999 to 2004. All laparoscopic surgeries were performed by one surgeon and robotic surgeries were performed by this surgeon or a laparoscopically naïve surgeon. Both groups were evaluated for perioperative outcome, pathologic status, and mid-term oncologic outcomes (5-year BCR-free rates at prostate-specific antigen [PSA] cutoffs of <0.4, <0.2, or <0.1 ng/ml). Baseline characteristics were equivalent except for age (61.9 years vs. 65.1 years, P < 0.0001). RALP operating time was shorter (215.5 min vs. 305.3, P < 0.0001), and resulted in fewer complications (3.8% vs. 10.3%, P = 0.0214) and blood transfusions (2.9% vs. 13.4%, P = 0.0003). Positive surgical margins were equivalent (pT2 20.9% vs. 28.8%, P = 0.1818). Overall 5-year BCR-free rates were comparable for RALP (97.6, 93.4, and 85.1%) and LRP (97.7, 89.7, and 79.7%) at PSA cutoff levels of <0.4, <0.2, and <0.1 ng/ml, respectively. There was a significant difference in BCR-free rates between the RALP and LRP groups for patients with organ-confined (pT2) disease at 0.2 ng/ml (96.4% vs. 88.7%, P = 0.0373) and 0.1 ng/ml (91.0% vs. 83.0%, P = 0.0470). We report lower morbidity, comparable pathologic outcome and improved mid-term oncologic results in patients with organ-confined disease after RALP in comparison to LRP.

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Conflict of interest

This work was supported through a grant provided by Intuitive Surgical in the year 2006 to the Geneva Foundation for Medical Education and Research for the development of an online clinical database. Usha Kreaden is Sr. Biostatistician for Intuitive Surgical and April Hebert is a Scientific Consultant for Intuitive Surgical.

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Authors and Affiliations

  1. Generale-Beaulieu Clinic, Chemin Beau Soleil 12, 1206, Geneva, Switzerland

    Charles-Henry Rochat, Jean Sauvain & Pierre Dubernard

  2. Department of Clinical Affairs, Intuitive Surgical, Sunnyvale, CA, USA

    April E. Hebert & Usha Kreaden

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  1. Charles-Henry Rochat
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  2. Jean Sauvain
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  3. Pierre Dubernard
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  4. April E. Hebert
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Correspondence to Charles-Henry Rochat.

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Rochat, CH., Sauvain, J., Dubernard, P. et al. Mid-term biochemical recurrence-free outcomes following robotic versus laparoscopic radical prostatectomy. J Robotic Surg 5, 251–257 (2011). https://doi.org/10.1007/s11701-011-0266-7

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  • DOI: https://doi.org/10.1007/s11701-011-0266-7

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