A recent study published in the World Journal of Urology, researchers have compared the outcomes of open retropubic radical prostatectomy (ORP) and robot-assisted radical prostatectomy (RARP) for treating prostate cancer. The study was conducted at a single tertiary referral center from 2008 to 2022 and analyzed data from a substantial cohort of 18,805 patients.
The research evaluated oncological, functional and surgical outcomes that were associated with both ORP and RARP procedures. After utilizing a propensity score-based matched cohort, the impact of the surgical approach on biochemical recurrence-free survival, salvage radiotherapy-free survival and metastasis-free survival was examined through log-rank tests and Kaplan–Meier analysis. Intraoperative and postoperative surgical outcomes were assessed with continence rates at 1 week, 3 months, and 12 months, as well as erectile function at 12 months post-surgery.
The results of the study revealed no statistically significant differences in oncological outcomes between the two surgical approaches. However, RARP demonstrated a slight advantage in terms of urinary continence recovery, with statistically significant differences observed at both the 3-month and 12-month marks. Also, the continence rates at 3 months were 81% for RARP when compared to 77% for ORP, and at 12 months, 91% for RARP when compared to 89.3% for ORP, respectively.
This study highlighted a significant disparity in erectile function outcomes, with RARP showing a markedly higher rate of erectile function recovery when compared to ORP. Also, RARP resulted in a 60% erectile function rate when compared to 45% for ORP that signifies a marked improvement in postoperative sexual function associated with the robotic approach. While both ORP and RARP demonstrated comparable oncological outcomes, RARP showed advantages in terms of urinary continence recovery and significant improved erectile function post-surgery.
Reference:
Ambrosini, F., Knipper, S., Tilki, D., Heinzer, H., Salomon, G., Michl, U., Steuber, T., Pose, R. M., Budäus, L., Maurer, T., Terrone, C., Tennstedt, P., Graefen, M., & Haese, A. (2024). Robot-assisted vs open retropubic radical prostatectomy: a propensity score-matched comparative analysis based on 15 years and 18,805 patients. In World Journal of Urology (Vol. 42, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1007/s00345-024-04824-6