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Outcomes assessment in men undergoing open retropubic radical prostatectomy, laparoscopic radical prostatectomy, and robotic-assisted radical prostatectomy

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Abstract

Objectives

To review the various methods of outcomes assessment used for effectiveness studies comparing retropubic radical prostatectomy (RRP), laparoscopic radical prostatectomy (LRP), and robotic-assisted laparoscopic prostatectomy (RALP).

Methods

A review of the peer reviewed literature was performed for reported series of RRP, LRP, and RALP using Pubmed and MEDLINE with emphasis on comparing perioperative, functional, and oncologic outcomes. Common methods used for outcomes assessment were categorized and compared, highlighting the pros and cons of each approach.

Results

The majority of the literature comparing RRP, LRP, and RALP comes in the form of observational data or administrative data from secondary datasets. While randomized controlled trials are ideal for outcomes assessment, only one such study was identified and was limited. Non-randomized observational studies contribute to the majority of data, however are limited due to retrospective study design, lack of consistent endpoints, and limited application to the general community. Administrative data provide accurate assessment of operative outcomes in both academic and community settings, however has limited ability to convey accurate functional outcomes.

Conclusions

Non-randomized observational studies and secondary data are useful resources for assessment of outcomes; however, limitations exist for both. Neither is without flaws, and conclusions drawn from either should be viewed with caution. Until standardized prospective comparative analyses of RRP, LRP, and RALP are established, comparative outcomes data will remain imperfect. Urologic researchers must strive to provide the best available outcomes data through accurate prospective data collection and consistent outcomes reporting.

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Acknowledgments

This manuscript is funded by the Robert and Kathy Salipante Minimally Invasive Urologic Research Fellowship (KJK), the American Urologic Association Foundation Research Fellowship (HY), the American Urologic Association Herbert Brendler Summer Medical Student Research Fellowship Award (WDU), the New York Academy of Medicine David E. Rogers Fellowship (WDU), and the Department of Defense Prostate Cancer Training Award W81XWH-08-1-0283 (JCH).

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Urologic Surgery, Brigham and Women’s Hospital, Harvard Medical School, 45 Francis St, ASB-II, Boston, MA, 02115, USA

    Keith J. Kowalczyk, Hua-yin Yu, Stephen B. Williams & Jim C. Hu

  2. Center For Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Jim C. Hu

  3. Harvard Medical School, Boston, MA, USA

    William Ulmer

Authors
  1. Keith J. Kowalczyk
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  2. Hua-yin Yu
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  3. William Ulmer
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  4. Stephen B. Williams
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  5. Jim C. Hu
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Corresponding author

Correspondence to Jim C. Hu.

Additional information

K. J. Kowalczyk and H. Yu contributed equally to share first authorship.

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Kowalczyk, K.J., Yu, Hy., Ulmer, W. et al. Outcomes assessment in men undergoing open retropubic radical prostatectomy, laparoscopic radical prostatectomy, and robotic-assisted radical prostatectomy. World J Urol 30, 85–89 (2012). https://doi.org/10.1007/s00345-011-0662-7

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  • DOI: https://doi.org/10.1007/s00345-011-0662-7

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