Does Surgical Technique Affect Outcomes in Patients With Prostate Cancer?
Posted: Thursday, September 6, 2018
A study recently published in The Lancet Oncology found that functional outcomes 24 months after surgery were similar for patients with prostate cancer who had undergone a robot-assisted laparoscopic prostatectomy and those who had been treated with an open radical retropubic prostatectomy. Geoffrey D. Coughlin, MBBS, FRACS, of the Royal Brisbane and Women’s Hospital, Australia, and colleagues also analyzed oncologic outcomes for these patients at 24 months. Outcomes were evaluated using the Expanded Prostate Cancer Index Composite (EPIC) and the International Index of Erectile Function Questionnaire (IIEF).
“We advise caution in interpreting the oncological outcomes of our study because of the absence of standardisation in postoperative management between the two trial groups and the use of additional cancer treatments,” Dr. Coughlin and colleagues concluded. “Clinicians and patients should view the benefits of a robotic approach as being largely related to its minimally invasive nature.”
Researchers found that urinary function scores after surgery remained similar for both groups at 6 months, 12 months, and 24 months. Sexual function scores for both groups also did not differ significantly after surgery at 6 months, 12 months, and 24 months. Evaluation of oncologic outcomes revealed a 3% biochemical recurrence in the robot-assisted laparoscopic prostatectomy group and a 9% recurrence in the open radical retropubic prostatectomy group, preventing the establishment of equality between the procedures. Superiority testing showed a significant difference between the groups (P = .0199). However, no significant difference (P = .2956) was indicated between the two groups in regard to patients who had imaging evidence of disease progression.
The randomized, controlled, phase III study enrolled 326 men between August 2010 and November 2014. Participants were randomly assigned 1:1 to undergo robot-assisted laparoscopic prostatectomy (n = 157) or open radical retropubic prostatectomy (n = 151).