14th Meeting of the EAU Robotic Urology Section
Prospective randomised controlled trial comparing laparoscopic versus robot-assisted radical prostatectomy: Oncological and functional outcomes after five years follow-up Eur Urol Suppl 2017; 16(6);e2267
Porpiglia F. 1 , Scarpa R.M. 1 , Manfredi M. 1 , Bertolo R. 1 , Mele F. 1 , Amaprore D. 1 , Garrou D. 1 , Checcucci E. 1 , Pecoraro A. 1 , De Cillis S. 1 , Piramide F. 1 , Passera R. 2 , Fiori C. 1 1
San Luigi Hospital, Dept. of Urology, Turin, Italy, 2Molinette S. Giovanni Battista Hospital, Dept. of Nuclear Medicine, Turin, Italy
Introduction & Objectives: The aim of this study was to report the 5-year functional and oncologic outcomes of our previously published prospective randomized study comparing RARP vs LRP. Material & Methods: From 1/2010 to 1/2011, 120 patients with organ-confined prostate cancer were enrolled and randomly assigned to RARP or LRP. All patients were treated by a single surgeon with a trans-peritoneal anterograde approach. Continence, potency and serum PSA were reported at 1,3,6,12 months and then every 6 months until the 60th month postoperatively. Complications for the survival analysis biochemical recurrence (BCR) was defined as any postoperative cancer treatment (radiation, hormonal/chemotherapy) or PSA above 0.2 ng/ml. A generalized estimating equations model was used to compare the time series of functional results, Kaplan-Meier and Cox model were used to analyse the oncologic outcomes. Results: The probability to be continent and potent over time was more than doubled in the RARP group (OR 2.47, p<0.021 and OR 2.35, p<0.028, respectively). Five years BCR Free Survival (BCRFS) was 81.6% for both the RARP and LRP groups. At Cox proportional hazards models pathological GS, positive surgical margins (PSMs) and pT (pT3a vs pT2; pT3b vs pT2) stage were associated with a significant increase of BCR risk (HR 3.74, 4.61, 2.80 and 12.69, respectively). None of the patients died due to oncological causes; conversely, three patients in the RARP group and two patients in the LRP group died due to cardiovascular events. Conclusions: All along the 5-yr follow-up, the robotic approach allows for better functional results if compared to pure laparoscopic, without compromising oncological outcomes.
Eur Urol Suppl 2017; 16(6);e2267