Comparison of oncological and health related quality of life (HRQOL) outcomes between open (ORP) and robotic-assisted radical prostatectomy (RARP) for localized prostate cancer - findings from the population-based Victorian Prostate Cancer Registry (PCR).

OBJECTIVE - To compare the short-term oncological and HRQOL outcomes between open (ORP) and robotic-assisted (RARP) radical prostatectomy in the population-based Victorian Prostate Cancer Registry (PCR).

PATIENTS AND METHODS - This is a prospective cohort of prostate cancer patients who had RP (1117 ORP and 885 RARP) between January 2009 and June 2012.

The oncological outcomes of interest were: positive surgical margin (PSM) and biochemical recurrence (BCR) (defined as post-operative PSA >0. 2ng/ml). The HRQOL outcomes were: sexual and urinary bother, assessed using the Expanded Prostate Cancer Index Composite (EPIC) at 1- and 2-year post-diagnosis. Student T-test or Mann-Whitney U-test were used for univariate comparison of continuous variables, and Pearson's chi-squared test for categorical variables. Bonferonni correction was applied to account for multiple testing, with threshold for significance of P

RESULTS - ORP and RARP patients were followed for a median of 19 months and 17 months respectively. The proportion of patients with NCCN low risk prostate cancer was significantly higher among RARP patients (21% vs. 26%; P=0. 002). The majority of RP was done in the private sector (77% ORP, and 85% RARP, P20 case/ year (P

CONCLUSIONS - We reported a large population-based comparative study on ORP and RARP with better short-term oncological outcomes favouring RARP, but no significant differences in HRQOL outcomes. The results have to be interpreted, taking into account significant surgeon heterogeneity, in a population-based study. This article is protected by copyright. All rights reserved.

BJU international. 2015 Nov 17 [Epub ahead of print]

Wee Loon Ong, Sue M Evans, Tim Spelman, Paul A Kearns, Declan G Murphy, Jeremy L Millar

Department of Urology, Alfred Health, Monash University. , Department of Epidemiology and Preventive Medicine, Monash University. , Department of Epidemiology and Preventive Medicine, Monash University. , Department of Urology, Barwon Health. , Division of Cancer Surgery Peter MacCallum Cancer Centre. , Department of Epidemiology and Preventive Medicine, Monash University.

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