Robot-assisted radical prostatectomy (RARP) for prostate cancer may offer superior oncologic outcomes compared with laparoscopic radical prostatectomy (LRP), according to the findings of a single-center study conducted in Japan.
Investigators who compared 250 patients who underwent LRP and 450 who underwent RARP at Kyorin University Hospital in Tokyo found that found that RARP was significantly associated with a 20% decreased risk of biochemical recurrence (BCR).
The 5-year BCR-free survival rate for the overall study population was significantly higher in the RARP than LRP group (83.4% vs 80%),Takatsugu Okegawa, MD, and colleagues at Kyorin University School of Medicine in Tokyo reported in Prostate International. The 5-year BCR-free survival rate also was significantly higher in RARP than LRP group among men with high-risk disease as defined by D’Amico criteria (65% vs 54%). The rates did not differ significantly among men with low- and intermediate-risk disease.
In addition, the study showed that RARP patients had a significantly lower positive surgical margin (PSM) rate than LRP patients (20.7% vs 31.2%).
The LRP and RARP groups were similar with regard to age and PSA level at diagnosis. The median patient age and PSA level were 68 years and 8.1 ng/mL for the LRP group and 66 years and 7.7 ng/mL for the RARP patients. The median follow-up was significantly longer for the LRP than RARP patients (61 vs 35 months).
Okegawa T, Omura S, Samejima M, et al. Laparoscopic radical prostatectomy versus robot-assisted radical prostatectomy: comparison of oncological outcomes at a single center. Prostate Int. 2020;8:16-21. doi: 10.1016/j.prnil.2019.09.004