Robot-assisted laparoscopic prostatectomy is not associated with early postoperative radiation therapy
Article first published online: 21 APR 2009
© 2009 THE AUTHORS. JOURNAL COMPILATION © 2009 BJU INTERNATIONAL
Volume 104, Issue 10, pages 1496–1500, November 2009
How to Cite
Chino, J., Schroeck, F. R., Sun, L., Lee, W. R., Albala, D. M., Moul, J. W. and Koontz, B. F. (2009), Robot-assisted laparoscopic prostatectomy is not associated with early postoperative radiation therapy. BJU International, 104: 1496–1500. doi: 10.1111/j.1464-410X.2009.08588.x
- Issue published online: 20 OCT 2009
- Article first published online: 21 APR 2009
- Accepted for publication 19 February 2009
- prostate cancer;
- robot-assisted laparoscopic prostatectomy;
- adjuvant therapy
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.
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).
RALP was not associated with an increase in either indication or referral for early postoperative RT.