14th Meeting of the EAU Robotic Urology Section
Prospective randomised controlled trial comparing laparoscopic versus robot-assisted radical prostatectomy: Long term complications and quality of life outcomes after five years follow-up Eur Urol Suppl 2017; 16(6);e2268
Porpiglia F. 1 , Scarpa R.M. 1 , Morra I. 1 , Manfredi M. 1 , Bertolo R. 1 , Mele F. 1 , Amparore D. 1 , Garrou D. 1 , Alleva G. 1 , Giordano A. 1 , Niculescu R.G. 1 , Toso S. 1 , Passera R. 2 , Fiori C. 1 1
San Luigi Hospital, Dept. of Urology, Turin, Italy, 2Molinette San Giovanni Battista Hospital, Dept. of Nuclear Medicine, Turin, Italy
Introduction & Objectives: Literature lacks of RCTs comparing robotic (RARP) and laparoscopic (LRP) radical prostatectomy, especially when looking for longer than one-year follow-up data. The aim of this study was to report 5 years results our previously published prospective randomized study comparing RARP vs LRP focusing on complications and patient’s quality of life. Material & Methods: From January 2010 to January 2011, 120 patients with organ-confined prostate cancer were enrolled and randomly assigned to RARP or LRP. A single surgeon performed all interventions, using the same trans-peritoneal anterograde technique. Follow up visits were planned at 1,3,6,12 months and then every 6 months until the 60th month postoperatively; complications and PSA serum measurement were assessed at each time points. At the end of the follow-up period, patients were administered q.1 (“In general, would you say your health is”: 1-Excellent; 2-Very good; 3-Good; 4-Fair; 5-Poor and) and q.46 (“Overall, how satisfied are you with treatment you received for your prostate disease intervention?” 1-extremely dissatisfied; 2-dissatisfied; 3-uncertain; 4-satisfied; 5-extremely satisfied) of the EPIC questionnaire to investigate their satisfaction with the intervention and general health status. Results: No difference in terms of oncologic results was found between the groups. No RP-related late surgical complications were recorded during the follow-up period in both groups. One patient in the RARP group and one in the LRP group had gross haematuria and underwent diagnostic cystoscopy without needing further treatment. Three patients in the LRP group underwent surgery for incontinence (“sling” in two cases, artificial sphincter in 1 case), successfully. Five years after surgery, 55/57 (96%) patients of the RARP group and 49/58 (84%) in the LRP group were “completely satisfied” or “satisfied” after the received surgery for prostate cancer (p=0.05). At the same time point, all patients of the RARP group and 50/58 (86%) evaluated as “excellent“, “very good” or “good” their own health status (p=0.003). Conclusions: Laparoscopic and robotic approaches are equally safe at long-term follow up. Overall, both techniques seemed to be appreciated by the patients, even if a significant difference was recorded in favour of RARP. Health status in RARP group was perceived as better by the patients.
Eur Urol Suppl 2017; 16(6);e2268