Comparative Effectiveness of Robot-Assisted and Open Radical Prostatectomy in the Postdissemination Era

Gandaglia, Giorgio; Sammon, Jesse D.; Chang, Steven L.; Choueiri, Toni K.; Hu, Jim C.; Karakiewicz, Pierre I.; Kibel, Adam S.; Kim, Simon P.; Konijeti, Ramdev; Montorsi, Francesco; Nguyen, Paul L.; Sukumar, Shyam; Menon, Mani; Sun, Maxine; Trinh, Quoc‐Dien

doi:10.1200/jco.2013.53.5096

Cited by 180 publications

(116 citation statements)

References 32 publications

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“…Multi-institutional collaboration between different surgeons from USA and Europe (like Dr Mani Menon, Dr Ashutosh Tewari, Dr Vipul Patel, and Dr Prasanna Sooriakumaran, to name a few) helped to formulate guidelines to achieve the ideal "trifecta" of outcomes (cancer control, potency and continence) [21e24]. Comparison of outcomes of open radical prostatectomy vs. RARP in the post-dissemination era found RARP to have lower 90-d overall rates of wound, respiratory, miscellaneous surgical and medical complications (all p < 0.04), lower postoperative transfusion rates and LOS (both p < 0.001) [25]. RARP resulted in significantly lesser PSM (even in intermediate and high-risk cases) and need for secondary cancer treatment at 6, 12 and 24 months after surgery [26].…”

Section: Evidence Synthesismentioning

confidence: 98%

WITHDRAWN: The growth of computer-assisted (robotic) surgery in urology 2000–2014: The role of Asian surgeons

Dalela¹,

Ahlawat²,

Sood³

et al. 2014

Asian Journal of Urology

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Objective: A major role in the establishment of computer-assisted robotic surgery (CARS) can be traced to the work of Mani Menon at Vattikuti Urology Institute (VUI), and of many surgeons of Asian origin. The success of robotic surgery in urology has spurred its acceptance in other surgical disciplines, improving patient comfort and disease outcomes and helping the industrial growth. The present paper gives an overview of the progress and development of robotic surgery, especially in the field of Urology; and to underscore some of the seminal work done by the VUI and Asian surgeons in the development of robotic surgery in urology in the US and around the world. Methods: PubMed/Medline and Scopus databases were searched for publications from 2000 through June 2014, using algorithms based on keywords "robotic surgery", "prostate", "kidney", "adrenal", "bladder", "reconstruction", and "kidney transplant". Inclusion criteria used were published full articles, book chapters, clinical trials, prospective and retrospective series, and systematic reviews/meta-analyses written in English language. Studies from Asian institutions or with the first/senior author of Asian origin were included for discussion, and focused on techniques of robotic surgery, relevant patient outcomes and associated demographic trends. Results: A total of 58 articles selected for final review highlight the important strides made by robots in urology, from robotic radical prostatectomy in 2000 to robotic kidney transplant in 2014. In the hands of an experienced robotic surgeon, it has been demonstrated to improve functional patient outcomes and minimize perioperative complications compared to open surgery, especially in urologic oncology and reconstructive urology. With increasing surgeon proficiency, the benefits of robotic surgery were consistently seen across different surgical disciplines, patient populations, and strata. (D. Dalela). Peer review under responsibility of Chinese Urological Association and SMMU. + MODEL Please cite this article in press as: Dalela D, et al., The growth of computer-assisted (robotic) surgery in urology 2000e2014: The role of Asian surgeons, Asian Journal of Urology (2015), http://dx.

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Section: Evidence Synthesismentioning

confidence: 98%

WITHDRAWN: The growth of computer-assisted (robotic) surgery in urology 2000–2014: The role of Asian surgeons

Dalela¹,

Ahlawat²,

Sood³

et al. 2014

Asian Journal of Urology

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“…In this context, studies based on several of these data sources have demonstrated that better outcomes might be achieved in high-volume hospitals and/or with more experienced surgeons [21,76]. The evaluation of large cohorts with follow-up data on cancer control has an important role in assessment of the safety and efficacy of PCa treatments [77][78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94]. Data on health-related quality of life after treatment can also be analyzed.…”

Section: 4mentioning

confidence: 99%

“…Comparative effectiveness of open versus robot-assisted RP [78] Impact of primary ADT on survival in men with clinically localized PCa [119] ADT and the risk of cardiovascular diseases, diabetes, fractures, and acute kidney injury in PCa patients [120,121] Racial disparities and geographic variations in primary treatments among PCa patients [64] Increased use of advanced treatment technologies among patients with low-risk PCa and high risk of non-cancer-related mortality [122] Cost implications of the introduction and widespread adoption of advanced treatment technologies for PCa [103] PCOS: Prostate Cancer Outcomes Study Association between age, race, and comorbidity and the probability of receiving a conservative treatment [67] Comparative effectiveness of radical prostatectomy and radiation therapy [37] 15-yr (long-term) disease-specific functional outcomes after RP and radiotherapy [35] …”

Section: 4mentioning

confidence: 99%

Prostate Cancer Registries: Current Status and Future Directions

Gandaglia¹,

Bray

Cooperberg

et al. 2016

European Urology

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Context: Disease-specific registries that enroll a considerable number of patients play a major role in prostate cancer (PCa) research. Objective: To evaluate available registries, describe their strengths and limitations, and discuss the potential future role of PCa registries in outcomes research. Evidence acquisition: We performed a literature review of the Medline, Embase, and Web of Science databases. The search strategy included the terms prostate cancer, outcomes, statistical approaches, population-based cohorts, registries of outcomes, and epidemiological studies, alone or in combination. We limited our search to studies published between January 2005 and January 2015. Evidence synthesis: Several population-based and prospective disease-specific registries are currently available for prostate cancer. Studies performed using these data sources provide important information on incidence and mortality, disease characteristics at presentation, risk factors, trends in utilization of health care services, disparities in access to treatment, quality of care, long-term oncologic and health-related quality of life outcomes, and costs associated with management of the disease. Although data from these registries have some limitations, statistical methods are available that can address certain biases and increase the internal and external validity of such analyses. In the future, improvements in data quality, collection of tissue samples, and the availability of data feedback to health care providers will increase the relevance of studies built on population-based and disease-specific registries. Conclusions: The strengths and limitations of PCa registries should be carefully considered when planning studies using these databases. Although randomized controlled trials still provide the highest level of evidence, large registries play an important and growing role in advancing PCa research and care. Patient summary: Several population-based and prospective disease-specific registries for prostate cancer are currently available. Analyses of data from these registries yield information that is clinically relevant for the management of patients with prostate cancer.

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“…The modality of RP is one such factor. While radical retropubic prostatectomy (RRP) has long been the gold standard extirpative therapy for localized prostate cancer, robot-assisted laparoscopic prostatectomy (RALP) is now the predominant surgical treatment approach [14]. RALP has been associated with lower rates of VUAS in multiple national population-based cohorts.…”

Section: Pathophysiologymentioning

confidence: 99%

The Devastated Bladder Outlet in Cancer Survivors After Local Therapy for Prostate Cancer

Sukumar

Elliott

2016

Curr Bladder Dysfunct Rep

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Prostate cancer is common; this combined with the long life expectancy after treatment has sparked a growing emphasis on prostate cancer survivorship care. An important goal of such care is preserving quality of life through ameliorating the side effects of therapy. Posterior urethral stenosis (PUS) can occur as a complication of radical prostatectomy (RP) and radiation therapy (RT). Evaluation includes a history, physical exam, uroflowmetry, lab tests, cystoscopy, and radiological studies. PUS is initially managed with endoscopic techniques such as dilation or internal urethrotomy. Patients who fail such therapies can be offered surgical reconstruction. Continence is an important factor in the management of PUS. In some cases, particularly after radiotherapy, the outlet may not be salvageable, and a permanent indwelling catheter or urinary diversion may be the only options. We review the evaluation of patients with the devastated bladder outlet: those undergoing repeat endoscopic treatments, surgical reconstruction, or urinary diversion.

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Comparative Effectiveness of Robot-Assisted and Open Radical Prostatectomy in the Postdissemination Era

Abstract: RARP and ORP have comparable rates of complications and additional cancer therapies, even in the postdissemination era. Although RARP was associated with lower risk of blood transfusions and a slightly shorter length of stay, these benefits do not translate to a decrease in expenditures.

Cited by 180 publications

References 32 publications

WITHDRAWN: The growth of computer-assisted (robotic) surgery in urology 2000–2014: The role of Asian surgeons

WITHDRAWN: The growth of computer-assisted (robotic) surgery in urology 2000–2014: The role of Asian surgeons

Prostate Cancer Registries: Current Status and Future Directions

The Devastated Bladder Outlet in Cancer Survivors After Local Therapy for Prostate Cancer

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