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- Title
Robot-assisted laparoscopic prostatectomy is not associated with early postoperative radiation therapy.
- Authors
Chino, Junzo; Schroeck, Florian R.; Sun, Leon; Lee, W. Robert; Albala, David M.; Moul, Judd W.; Koontz, Bridget F.
- Abstract
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.
- Subjects
PROSTATE cancer; MEDICAL robotics; PROSTATECTOMY; RADIOTHERAPY; ADJUVANT treatment of cancer; MULTIVARIATE analysis
- Publication
BJU International, 2009, Vol 104, Issue 10, p1496
- ISSN
1464-4096
- Publication type
Article
- DOI
10.1111/j.1464-410X.2009.08588.x