Robotic Prostate Surgery Implicated in PLND Decline

PLND in high-risk patients is 2.5x more likely in those undergoing open surgery.
PLND in high-risk patients is 2.5x more likely in those undergoing open surgery.

STOCKHOLM—Robotic-assisted radical prostatectomy (RARP) is associated with decreased use of pelvic lymph node dissection (PLND), according to study findings presented at the European Association of Urology 29th annual meeting.

Using the Surveillance Epidemiology and End Results Medicare-linked database, researchers analyzed data from 5,804 patients with non-metastatic PCa, which included 1,512 patients with high-risk PCa. Patients with low-, intermediate-, and high-risk prostate cancer (PCa) who underwent open radical prostatectomy (ORP) had a significant 4.0, 2.5, and 2.5 times greater likelihood of PLND, respectively, than patients undergoing RARP, Giorgio Gandaglia, MD, of Vita Salute San Raffaele University, Urological Research Institute, Milan, Italy, and colleagues reported.

Among patients with high-risk disease, those who underwent ORP had a significant 52% greater likelihood of extended PLND compared with those who underwent RARP. The likelihood of extended PLND did not differ significantly between the ORP and RARP groups among patients with low- and intermediate-risk PCa.

Dr. Gandaglia's group also compared perioperative outcomes in high-risk patients and found that RARP was associated with a significant 75% decreased risk of requiring heterologous blood transfusions and a significant 82% decreased likelihood of requiring a hospital stay longer than 3 days.

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