Robot-assisted radical prostatectomy vs. open radical prostatectomy: latest evidences on perioperative, functional and oncological outcomes

Purpose of review Despite increasing use of robotic surgery for radical prostatectomy, the benefit of robotic over open approach on different postoperative outcomes is still under debate. The present review aimed to provide a framework on the latest evidences on outcomes of prostate cancer (PCa) patients treated with robot-assisted radical prostatectomy (RARP) vs. open radical prostatectomy (ORP). Specifically, we focused on postoperative complications, urinary continence and erectile function recovery, PCa recurrence and PCa-related mortality. Recent findings Regarding perioperative outcomes, recent studies confirmed lower blood loss, transfusion rates and shorter catheterization time for RARP compared with ORP. Postoperative complications are lower in retrospective analyses, but this trend was not confirmed in prospective studies. Functional outcomes are comparable between RARP and ORP, with a slight nonclinically meaningful benefit in favour of RARP. The mid-term update of a recent randomized trial showed better oncological outcomes at 24 months, but the strength of this finding is limited by methodological flaws. Conversely, contemporary retrospective studies did not demonstrate differences in terms of biochemical recurrence between the two surgical approaches. Summary The recent large uptake of RARP relative to ORP was sustained by evidences showing improved perioperative outcomes but not clear benefit on functional and oncological outcomes.
Source: Current Opinion in Urology - Category: Urology & Nephrology Tags: ROBOTIC SURGERY IN UROLOGY: FACTS AND REALITY: Edited by Firas Abdollah and Alexandre Mottrie Source Type: research

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ConclusionsNeither race nor predominant tumor location was associated with adverse oncologic outcome.
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Conclusion: There is strong evidence from two independent populations of a considerably higher early to midterm mortality after prostatectomy compared to radiotherapy extending the time of early mortality considered by previous studies up to 36-months.
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Conclusion 68Ga-PSMA PET-CT allows accurate detection of lymphnodal metastases in patients with intermediate-risk and high-risk prostate cancer prior to definitive surgical treatment. It performed better than mp-MRI in a subset of patients.
Source: Nuclear Medicine Communications - Category: Nuclear Medicine Tags: Original Articles Source Type: research
Conclusions This case study demonstrates that an aerobically trained prostate cancer patient can return to high-level aerobic training in as little as 7 wk post-RP, and even exceed presurgery fitness. This finding has implications for prognosis given the beneficial effect of vigorous-intensity exercise on prostate cancer progression.
Source: Medicine and Science in Sports and Exercise - Category: Sports Medicine Tags: CLINICAL SCIENCES Source Type: research
Abstract The oncological benefit of pelvic lymph node dissection (PLND) for prostate cancer (PCa) remains unclear. The therapeutic effect of PLND on the elimination of microscopic metastases during radical prostatectomy (RP) for PCa was examined in the current study. A total of 348 Japanese patients with high- or intermediate-risk PCa without lymph node metastasis, who underwent antegrade RP at the Kyushu Cancer Center (Fukuoka, Japan) between August 1998 and May 2013 were retrospectively analyzed. The patients were divided into the standard (obturator + internal iliac nodes) group and the expanded (standard + add...
Source: Clinical Prostate Cancer - Category: Cancer & Oncology Authors: Tags: Mol Clin Oncol Source Type: research
Conclusion: The plasma 16S rDNA levels increased in patients with PCa who have biochemical recurrence and 16S rDNA levels were higher in patients with higher-grade PCa.
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
;t M Abstract OBJECTIVE: Evaluate the safety, feasibility and efficiency of robot-assisted radical prostatectomy (RARP) in kidney transplant recipients, performed in high-volume French referral centres, and describe intra- and postoperative, oncological and functional outcomes. MATERIALS AND METHODS: A multicentre study was conducted on prospective RARP databases from 5 centres between 2008 and 2017. We retrospectively identified a first group (G1) of transplant patients. The following data were collected: age, body mass index, prostate-specific antigen, ISUP score, TNM stage, stratification according to d'Am...
Source: Urologic Oncology - Category: Urology & Nephrology Authors: Tags: Urol Oncol Source Type: research
Mohamad Waseem SalkiniUrology Annals 2020 12(1):1-3 The traditional open retropubic radical prostatectomy has an established role in the treatment of prostate cancer. However, it is well known to be morbid procedure with high complication rate. This bad reputation prevented utilizing it on a large scale for high risk prostate cancer. Utilizing the da Vinci® to preform radical prostatectomy decreased the morbidity of the procedure. Since the introduction of robotic prostatectomy, there have been hot debates on its role in the treatment of high risk disease. In this article we reviewed the current evidence on utilizing...
Source: Urology Annals - Category: Urology & Nephrology Authors: Source Type: research
Authors: Morrison BF, Aiken WD, Reid G, Mayhew R, Hanchard B Abstract Several studies suggest race-based health disparities in men with low-risk prostate cancer (PCa), with African American males having poorer oncological outcomes. We sought to determine the prevalence and predictors of pathological upgrading and upstaging in Jamaican men with low-risk PCa treated with radical prostatectomy (RP). Data on 141 men who met the National Comprehensive Cancer Network criteria for low-risk PCa and underwent RP at a single institution were reviewed. All men had a transrectal ultrasound-guided biopsy. Pre-operative clinical...
Source: Ecancermedicalscience - Category: Cancer & Oncology Tags: Ecancermedicalscience Source Type: research
ConclusionsLRP showed higher surgical time, less complications and it didn’t influence the hospital stay.ResumenIntroducciónExisten muy pocos estudios que comparen la prostatectomía radical abierta (PRA) con la prostatectomía radical laparoscópica (PRL).ObjetivosComparar el tiempo quirúrgico, las complicaciones postoperatorias y la estancia hospitalaria en los pacientes con cáncer de próstata clínicamente localizado tratados mediante PRA y PRL.Material y métodoComparación de dos cohortes (312 con PRA y 206 con PRL) entre 2007 y 2015. Las complicaci...
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Source Type: research
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