Robot-assisted laparoscopic prostatectomy is not associated with early postoperative radiation therapy.


Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Chino, J; Schroeck, FR; Sun, L; Lee, WR; Albala, DM; Moul, JW; Koontz, BF

Published Date

  • November 2009

Published In

Volume / Issue

  • 104 / 10

Start / End Page

  • 1496 - 1500

PubMed ID

  • 19388991

Pubmed Central ID

  • 19388991

Electronic International Standard Serial Number (EISSN)

  • 1464-410X

Digital Object Identifier (DOI)

  • 10.1111/j.1464-410X.2009.08588.x


  • eng

Conference Location

  • England