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Robot‐assisted laparoscopic prostatectomy is not associated with early postoperative radiation therapy
Author(s) -
Chino Junzo,
Schroeck Florian R.,
Sun Leon,
Lee W. Robert,
Albala David M.,
Moul Judd W.,
Koontz Bridget F.
Publication year - 2009
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2009.08588.x
Subject(s) - medicine , stage (stratigraphy) , prostatectomy , urology , odds ratio , prostate cancer , cancer , paleontology , biology
OBJECTIVE To compare open radical prostatectomy (RP) and robot‐assisted laparoscopic prostatectomy (RALP), and to determine whether RALP is associated with a higher risk of features that determine recommendations for postoperative radiation therapy (RT). PATIENTS AND METHODS Patients undergoing RP from 2003 to 2007 were stratified into two groups: open RP and RALP. Preoperative (PSA level, T stage and Gleason score), pathological factors (T stage, Gleason score, extracapsular extension [ECE] and the status of surgical margins and seminal vesicle invasion [SVI]) and early treatment with RT or referral for RT within 6 months were compared between the groups. Multivariate analysis was used to control for selection bias in the RALP group. RESULTS In all, 904 patients were identified; 368 underwent RALP and 536 underwent open RP (retropubic or perineal). Patients undergoing open RP had a higher pathological stage with ECE present in 24.8% vs 19.3% in RALP ( P = 0.05) and SVI in 10.3% vs 3.8% ( P < 0.001). In the RALP vs open RP group, there were positive surgical margins in 31.5% vs 31.9% ( P = 0.9) and there were postoperative PSA levels of 3 0.2 ng/mL in 5.7% vs 6.3% ( P = 0.7), respectively. On multivariate analysis to control for selection bias, RALP was not associated with indication for RT (odds ratio (OR) 1.10, P = 0.55), or referral for RT (OR 1.04, P = 0.86). CONCLUSION RALP was not associated with an increase in either indication or referral for early postoperative RT.