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Long-term cancer control outcomes of robot-assisted radical prostatectomy for prostate cancer treatment: a meta-analysis

  • Urology - Original Paper
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Abstract

Purpose

Robot-assisted radical prostatectomy (RARP) provides significant advantages in short-term oncological outcomes for prostate cancer patients. However, data regarding the long-term cancer control outcomes of RARP are limited and inconsistent. This study aimed to evaluate these long-term outcomes.

Methods

Medline, Scopus, and other databases were searched for studies published from January 2010 to July 2016. Case series and prospective cohort studies on the long-term cancer control outcomes of patients who underwent RARP were subjected to meta-analyses by using the R statistical software. The rates of 5- and 10-year biochemical recurrence-free survival (BCRFS) and cancer-specific survival (CSS) were extracted from the included studies to assess these outcomes.

Results

Twenty studies involving RARP with more than 5 years of follow-up were included. The pooled proportions of the 5-year BCRFS and CSS from 20 and 4 studies on RARP were 80% [95% confidence interval (CI) 0.77–0.82] and 97% (95% CI 0.96–0.98), respectively. The 10-year BCRFS rate from 5 studies was 79% (95% CI 0.72–0.86). Compared with the rate observed in open radical prostatectomy (ORP), the pooled 5-year BCRFS rate in the RARP group from 5 studies was significantly increased (P < 0.001, odds ratio 1.10, 95% CI 1.03–1.16). Their survival hazard ratios did not significantly differ (log rank P > 0.05). The effect size of the 5-year BCRFS was greater in the samples from the USA than in the samples from other regions (Z = − 10.424, P < 0.001). Publication date and clinical baselines, including preoperative PSA, Gleason scores, pathological stage, margin positive rate, lymph-node positive rate, and adjuvant therapy, also influenced the effect size of BCRFS (P < 0.001).

Conclusions

The meta-analysis of long-term cancer control outcomes demonstrated that RARP yielded satisfactory long-term BRFS and CSS, although the former was influenced by clinical baselines and unbalanced operative technological advantages in different study regions and years. The long-term BCRFS rates of RARP were higher than those of ORP, but the advantages of these survivals from these procedures were similar.

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Acknowledgements

The authors thank Yu Xiao (Chengdu Fx biological technology co., LTD) to assist with the preparation and proof reading of data and the manuscript.

Authors’ contribution

LW, BW, and XZ involved in protocol/project development; LW, BW, QA, YZ, and XL involved in data collection or management; HL and XM involved in data analysis; LW and XZ involved in manuscript writing/editing.

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Authors and Affiliations

  1. Department of Urology, Chinese PLA General Hospital, Medical School of Chinese PLA, No. 28, Fuxing Road, Beijing, 100853, China

    Lei Wang, Baojun Wang, Qing Ai, Yu Zhang, Xiangjun Lv, Hongzhao Li, Xin Ma & Xu Zhang

  2. Department of Urology I, Xinxiang Central Hospital, Xinxiang, Henan, China

    Lei Wang

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  1. Lei Wang
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  2. Baojun Wang
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  3. Qing Ai
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Correspondence to Xu Zhang.

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The present study is a meta-analysis of pooled data; the authors did not apply for ethics review committee.

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Wang, L., Wang, B., Ai, Q. et al. Long-term cancer control outcomes of robot-assisted radical prostatectomy for prostate cancer treatment: a meta-analysis. Int Urol Nephrol 49, 995–1005 (2017). https://doi.org/10.1007/s11255-017-1552-8

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