Tags

Type your tag names separated by a space and hit enter

Benchmarks for operative outcomes of robotic and open radical prostatectomy: results from the Health Professionals Follow-up Study.
Eur Urol. 2015 Mar; 67(3):432-8.EU

Abstract

BACKGROUND

Robot-assisted laparoscopic radical prostatectomy (RALP) has become increasingly common; however, there have been no nationwide, population-based, non-claims-based studies to evaluate differences in outcomes between RALP and open radical retropubic prostatectomy (RRP).

OBJECTIVE

To determine surgical, oncologic, and health-related quality of life (HRQOL) outcomes following RALP and RRP in a nationwide cohort.

DESIGN, SETTING, AND PARTICIPANTS

We identified 903 men in the Health Professionals Follow-up Study diagnosed with prostate cancer between 2000 and 2010 who underwent radical prostatectomy using RALP (n=282) or RRP (n=621) as primary treatment.

INTERVENTION

Radical prostatectomy.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

We compared patients undergoing RALP or RRP across a range of perioperative, oncologic, and HRQOL outcomes.

RESULTS AND LIMITATIONS

Use of RALP increased during the study period, constituting 85.2% of study subjects in 2009, up from 4.5% in 2003. Patients undergoing RALP compared to RRP were less likely to have a lymph node dissection (51.5% vs 85.4%; p<0.0001), had less blood loss (207.4 ml vs 852.3 ml; p<0.0001), were less likely to receive blood transfusions (4.3% vs 30.3%; p<0.0001), and had shorter hospital stays (1.8 d vs 2.9 d; p<0.0001). Surgical, oncologic, and HRQOL outcomes did not differ significantly among the groups. In multivariate logistic regression models, there were no significant differences in 3- or 5-yr recurrence-free survival comparing RALP versus RRP (hazard ratios: 0.98 [95% confidence interval (CI), 0.46-2.08] and 0.75 [95% CI, 0.18-3.11], respectively).

CONCLUSIONS

In a nationwide cohort of patients undergoing surgical treatment for prostate cancer, RALP was associated with shorter hospital stay, and lower blood loss and transfusion rates than RRP. Surgical oncologic and HRQOL outcomes were similar between groups.

PATIENT SUMMARY

We studied men throughout the United States with prostate cancer who underwent surgical removal of the prostate. We found that robot-assisted laparoscopic radical prostatectomy resulted in shorter hospital stay, less blood loss, and fewer blood transfusions than radical retropubic prostatectomy. There were no differences in cancer control or health-related quality of life.

Authors+Show Affiliations

USC Institute of Urology, Keck Medical Center at USC, Los Angeles, CA, USA. Electronic address: malemozaffar@gmail.com.Department of Urology, Emory University School of Medicine, Atlanta, GA, USA.Boston University School of Medicine, Boston, MA, USA.Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.Department of Urology, University of California, San Francisco, CA, USA.

Pub Type(s)

Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24582327

Citation

Alemozaffar, Mehrdad, et al. "Benchmarks for Operative Outcomes of Robotic and Open Radical Prostatectomy: Results From the Health Professionals Follow-up Study." European Urology, vol. 67, no. 3, 2015, pp. 432-8.
Alemozaffar M, Sanda M, Yecies D, et al. Benchmarks for operative outcomes of robotic and open radical prostatectomy: results from the Health Professionals Follow-up Study. Eur Urol. 2015;67(3):432-8.
Alemozaffar, M., Sanda, M., Yecies, D., Mucci, L. A., Stampfer, M. J., & Kenfield, S. A. (2015). Benchmarks for operative outcomes of robotic and open radical prostatectomy: results from the Health Professionals Follow-up Study. European Urology, 67(3), 432-8. https://doi.org/10.1016/j.eururo.2014.01.039
Alemozaffar M, et al. Benchmarks for Operative Outcomes of Robotic and Open Radical Prostatectomy: Results From the Health Professionals Follow-up Study. Eur Urol. 2015;67(3):432-8. PubMed PMID: 24582327.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Benchmarks for operative outcomes of robotic and open radical prostatectomy: results from the Health Professionals Follow-up Study. AU - Alemozaffar,Mehrdad, AU - Sanda,Martin, AU - Yecies,Derek, AU - Mucci,Lorelei A, AU - Stampfer,Meir J, AU - Kenfield,Stacey A, Y1 - 2014/02/11/ PY - 2013/11/18/received PY - 2014/01/31/accepted PY - 2014/3/4/entrez PY - 2014/3/4/pubmed PY - 2015/12/15/medline KW - Health-related quality of life KW - Open KW - Outcomes KW - Prostatectomy KW - Robotic SP - 432 EP - 8 JF - European urology JO - Eur Urol VL - 67 IS - 3 N2 - BACKGROUND: Robot-assisted laparoscopic radical prostatectomy (RALP) has become increasingly common; however, there have been no nationwide, population-based, non-claims-based studies to evaluate differences in outcomes between RALP and open radical retropubic prostatectomy (RRP). OBJECTIVE: To determine surgical, oncologic, and health-related quality of life (HRQOL) outcomes following RALP and RRP in a nationwide cohort. DESIGN, SETTING, AND PARTICIPANTS: We identified 903 men in the Health Professionals Follow-up Study diagnosed with prostate cancer between 2000 and 2010 who underwent radical prostatectomy using RALP (n=282) or RRP (n=621) as primary treatment. INTERVENTION: Radical prostatectomy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We compared patients undergoing RALP or RRP across a range of perioperative, oncologic, and HRQOL outcomes. RESULTS AND LIMITATIONS: Use of RALP increased during the study period, constituting 85.2% of study subjects in 2009, up from 4.5% in 2003. Patients undergoing RALP compared to RRP were less likely to have a lymph node dissection (51.5% vs 85.4%; p<0.0001), had less blood loss (207.4 ml vs 852.3 ml; p<0.0001), were less likely to receive blood transfusions (4.3% vs 30.3%; p<0.0001), and had shorter hospital stays (1.8 d vs 2.9 d; p<0.0001). Surgical, oncologic, and HRQOL outcomes did not differ significantly among the groups. In multivariate logistic regression models, there were no significant differences in 3- or 5-yr recurrence-free survival comparing RALP versus RRP (hazard ratios: 0.98 [95% confidence interval (CI), 0.46-2.08] and 0.75 [95% CI, 0.18-3.11], respectively). CONCLUSIONS: In a nationwide cohort of patients undergoing surgical treatment for prostate cancer, RALP was associated with shorter hospital stay, and lower blood loss and transfusion rates than RRP. Surgical oncologic and HRQOL outcomes were similar between groups. PATIENT SUMMARY: We studied men throughout the United States with prostate cancer who underwent surgical removal of the prostate. We found that robot-assisted laparoscopic radical prostatectomy resulted in shorter hospital stay, less blood loss, and fewer blood transfusions than radical retropubic prostatectomy. There were no differences in cancer control or health-related quality of life. SN - 1873-7560 UR - https://www.unboundmedicine.com/medline/citation/24582327/Benchmarks_for_operative_outcomes_of_robotic_and_open_radical_prostatectomy:_results_from_the_Health_Professionals_Follow_up_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(14)00118-3 DB - PRIME DP - Unbound Medicine ER -