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Does Robotic Prostatectomy Meet Its Promise in the Management of Prostate Cancer?

Current Urology Reports volume 14, pages 184–191 (2013)Cite this article

Abstract

Following Walsh’s advances in pelvic anatomy and surgical technique to minimize intraoperative peri-prostatic trauma more than 30 years ago, open retropubic radical prostatectomy (RRP) evolved to become the gold standard treatment of localized prostate cancer, with excellent long-term survival outcomes [1•]. However, RRP is performed with great heterogeneity, even among high volume surgeons, and subtle differences in surgical technique result in clinically significant differences in recovery of urinary and sexual function. Since the initial description of robotic-assisted radical prostatectomy (RARP) in 2000 [2], and U.S. Food and Drug Administration approval shortly thereafter, RARP has been rapidly adopted and has overtaken RRP as the most popular surgical approach in the management of prostate cancer in the United States [3]. However, the surgical management of prostate cancer remains controversial. This is confounded by the idolatry of new technologies and aggressive marketing versus conservatism in embracing tradition. Herein, we review the literature to compare RRP to RARP in terms of perioperative, oncologic, and quality-of-life outcomes as well as healthcare costs. This is a particularly relevant, given the absence of randomized trials and long-term (more than 10-year) follow-up for RARP biochemical recurrence-free survival.

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Disclosure

Dr. Kuo-How Huang reported no potential conflicts of interest relevant to this article.

Dr. Stacey C. Carter reported no potential conflicts of interest relevant to this article.

Dr. Jim C. Hu reported no potential conflicts of interest relevant to this article.

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Authors and Affiliations

  1. Institute of Urologic Oncology, Department of Urology, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd, Suite 1000, Los Angeles, CA, 90024, USA

    Kuo-How Huang, Stacey C. Carter & Jim C. Hu

  2. Department of Urology, National Taiwan University Hospital, Taipei, Taiwan

    Kuo-How Huang

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  1. Kuo-How Huang
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  2. Stacey C. Carter
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  3. Jim C. Hu
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Correspondence to Jim C. Hu.

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Huang, KH., Carter, S.C. & Hu, J.C. Does Robotic Prostatectomy Meet Its Promise in the Management of Prostate Cancer?. Curr Urol Rep 14, 184–191 (2013). https://doi.org/10.1007/s11934-013-0327-8

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Keywords

  • Prostate cancer
  • Open retropubic radical prostatectomy
  • Outcomes
  • Robotic-assisted radical prostatectomy
  • Oncological
  • Outcomes
  • Continence
  • Potency