Robotic-Assisted Prostate Surgery May Offer Better Cancer Control Than Open Radical Prostatectomy
An observational study from UCLA’s Jonsson Comprehensive Cancer Center comparing robotic-assisted surgery to traditional surgery for prostate cancer found that patients who had robotic surgery had fewer instances of cancer cells remaining after surgery and less need of additional cancer treatments than patients who had traditional surgery. The study by Hu et al was published in European Urology.
Robotic-assisted radical prostatectomy has remained controversial because there has been little evidence of better cancer control over open radical prostatectomy.
Study Details
In an effort to determine the comparative effectiveness of robotic surgery, the investigators conducted a retrospective study comparing 5,556 patients who received robotic-assisted radical prostatectomy to 7,878 patients who received open radical prostatectomy during the years 2004 and 2009. Data were provided by Surveillance, Epidemiology, and End Results (SEER)-Medicare. The researchers compared the two groups by surgical margin status and the use of additional cancer therapy (androgen deprivation and radiation) after robotic vs open surgery.
The investigators found that robotic-assisted radical prostatectomy was associated with 5% fewer positive surgical margins than open radical prostatectomy, 13.6% vs 18.3% (odds ratio [OR] = 0.70, 95% confidence interval [CI] = 0.66–0.75). This difference was greater for patients with intermediate- (15.0% vs 21%) and high-risk (15.1% vs 20.6%) prostate cancer. Patients who had robotic surgery also had a one-third reduction in likelihood of using additional cancer therapy within 24 months after robotic surgery compared to open surgery (OR = 0.67, 95% CI = 0.57–0.78).
According to the authors, the study findings show that despite a greater upfront cost of robotic surgery, the fewer positive surgical margins and less need for radiation therapy after robotic surgery may translate into fewer downstream costs and radiation and hormone therapy side effects.
Jim C. Hu, MD, of the David Geffen School of Medicine at UCLA, is the corresponding author for the European Urology article.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
