Robotic radical prostatectomy shows less morbidity than open technique

Key Points

Washington-Early results from a prospective, randomized trial of men with clinically localized prostate cancer demonstrate robot-assisted laparoscopic prostatectomy (RALP) is a safe technique associated with less morbidity than open retropubic radical prostatectomy, Brazilian researchers reported at the AUA annual meeting.

"To our knowledge, this is the first prospective, randomized trial comparing open and robotic RP for the treatment of localized prostate cancer, and our main objectives are to analyze perioperative differences and functional outcomes through 1 year," said co-author Alberto Azoubel Antunes, MD, PhD, assistant professor of urology at the University of São Paolo Medical School.

"Now, longer follow-up and data from other randomized trials are needed to reach conclusions about the relative outcomes of these techniques and whether there are specific criteria for patient selection."

Principal investigator Carlo Passerotti, MD, performed all of the robotic procedures, and co-author Adriano J. Nesrallah, MD, performed all of the open surgeries. Both surgeons were highly experienced in their technique.

At enrollment, there were no clinically relevant differences between the men in terms of demographic or tumor-related characteristics. The intraoperative data showed that open prostatectomy was significantly faster than RALP (mean surgical time, 94.3 minutes vs. 138.4 minutes). However, the open technique was associated with significantly greater blood loss compared with RALP (972 mL vs. 289 mL), and mean hemoglobin and hematocrit levels were also significantly lower after open surgery versus RALP. Two open surgery patients required transfusion.