OBJECTIVES: To perform a systematic bibliographic review of the literature assessing the quality of life and complications of robotic prostatectomy (RP) versus low-dose rate brachytherapy (LDR-BT) in patients with localized prostate cancer (PCa).
PubMed, EMBASE and Cochrane, Centre for Reviews and Dissemination, Emergency Care Research Institute, Web of Knowledge, Technology Evaluation Center, Clinical Evidence, Uptodate, Hayes and Drug Effectiveness Review Project. Systematic reviews and prospective studies comparing RP to LDR-BT in men with localized PCa were included. The primary outcome was quality of life and the secondary endpoint complications rate.
RESULTS: Three systematic reviews and four prospective studies were included. RP showed better results than LDR-BT for SF-12-physical domain (p< 0.01) and faster recovery to pre-operative scores. LDR-BT improved scores for UCLAPCI questionnaire-urinary and sexual domains compared to RP during the first three years of follow-up (p< 0.001). First postoperative year urinary incontinence rate was favorable for LDR-BT (88.0% vs 84.5%, p< 0.001). No differences for intestinal function scores for the first three post-intervention years (p = 0.02) were found. Major complications of LDR-BT were gastrointestinal and genitourinary toxicity, although pooled weighted events rate of the studies was not analyzed.
CONCLUSIONS: LDR-BT improves quality of life in terms of urinary and sexual function in patients with localized PCa vs RP during the first three years post-intervention.
Martín-López JE, Rodríguez-López R, Romero-Tabares A, Beltran-Calvo C, Molina-López T, Baena-González V. Are you the author?
Agencia de Evaluación de Tecnologías Sanitarias de Andalucía, Sevilla, España.
Reference: Arch Esp Urol. 2015 Mar;68(2):142-151.
Article in English, Spanish.