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Ham, Park, Rha, and Choi: Comparison of Open versus Robotic Radical Prostatectomy in Clinically Advanced Prostate Cancer
Original Article
Korean Journal of Urology

Korean Journal of Urology 2008; 49(10): 886-892.

Published online: 31 October 2008

DOI: https://doi.org/10.4111/kju.2008.49.10.886

Comparison of Open versus Robotic Radical Prostatectomy in Clinically Advanced Prostate Cancer

Won Sik Ham, Sung Yul Park, Koon Ho Rha, Young Deuk Choi

Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

youngd74@yuhs.ac

Received 25 January 2008       Accepted 9 September 2008

Copyright © 2008 The Korean Urological Association

Abstract

Purpose

To evaluate the outcomes of robotic prostatectomy (RP) compared with open radical prostatectomy (OP) in clinically advanced prostate cancer (PC).

Materials and Methods

Between January 2003 and June 2007 we performed radical prostatectomy in 180 patients with clinically advanced PC (OP, 88; RP, 92). We compared the perioperative parameters and early surgical outcomes between the OP and RP groups in patients with and without neoadjuvant hormonal therapy (NHT).

Results

In patients without NHT, there were no significant differences in preoperative characteristics between the OP and RP groups, but in patients with NHT, the RP patients had higher biopsy Gleason scores (GS) and clinical stages. There were no significant differences in lymph node (LN) invasion and extracapsular extension (ECE), but a significant difference existed in the prostatectomy GS between the OP and RP groups, regardless of NHT. The positive surgical margin rates in the RP group were similar to or lower than in the OP groups when stratified by pathologic stages T2 and T3. Irrespective of NHT, in the RP group the mean estimated blood loss was decreased, the mean duration of the hospital stay was less, and the length of bladder catheterization was shorter, but there were no significant differences in the postoperative day the regular diet was started or the frequency of complications. Although there were no significant differences in continence rates between the two groups, all the RP patients had a higher continence rate from 1 month postoperatively, with or without NHT.

Conclusions

Our results suggest that RP may be performed safely and may have results comparable to OP in clinically advanced PC.

Keywords: Prostatic neoplasms, Open radical prostatectomy, Robotic radical prostatectom

Figures and Tables

Table 1
Preoperative patient characteristics
kju-49-886-i001

BMI: body mass index, NHT: neoadjuvant hormonal therapy, OP: open radical retropubic prostatectomy, PSA: prostate-specific antigen, RP: robotic radical prostatectomy. *: Student's t-test, †: Fisher's exact test

Table 2
Intraoperative and perioperative parameters based on the operative methods
kju-49-886-i002

Mean±SD, ECE: extracapsular extension, EBL: estimated blood loss, LN: lymph node, NHT: neoadjuvant hormonal therapy, OP: open radical retropubic prostatectomy, RP: robotic radical prostatectomy. *: Student's t-test, †: Fisher's exact test, ‡: chi-square test

Table 3
Complications based on the operative methods
kju-49-886-i003

NHT: neoadjuvant hormonal therapy, OP: open radical retropubic prostatectomy, RP: robotic radical prostatectomy, *: Fisher's exact test

Table 4
Return of continence based on the operative methods
kju-49-886-i004

NHT: neoadjuvant hormonal therapy, OP: open radical retropubic prostatectomy, RP: robotic radical prostatectomy, *: chi-square test

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