Radical Retropubic Prostatectomy and Robotic-assisted Laparoscopic Prostatectomy: Likelihood of Positive Surgical Margin(s)

Williams, Stephen B.; Chen, Ming Hui; D’Amico, Anthony V.; Weinberg, Aaron; Kacker, Ravi; Hirsch, Michelle S.; Richie, Jerome P.; Hu, Jim C.

doi:10.1016/j.urology.2009.11.079

Cited by 68 publications

(55 citation statements)

References 28 publications

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“…A recently reported randomised controlled trial (RCT) of pelvic floor muscle therapy following radical prostatectomy demonstrated that the rate of urinary incontinence beyond 12 months using patient-reported measures and data collection independent of the clinical team was higher than that given by most of the studies used in our meta-analysis. 77 …”

Section: Urinary Incontinencementioning

confidence: 99%

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Systematic review and economic modelling of the relative clinical benefit and cost-effectiveness of laparoscopic surgery and robotic surgery for removal of the prostate in men with localised prostate cancer.

Ramsay

Pickard²,

Robertson³

et al. 2012

Health Technol Assess

171

166

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projec...

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Section: Urinary Incontinencementioning

confidence: 99%

“…77 We did not apply costs related to outpatient visits for follow-up or GP visits for associated care. Patient costs and societal costs were also not included.…”

Section: Equipment Costsmentioning

confidence: 99%

Systematic review and economic modelling of the relative clinical benefit and cost-effectiveness of laparoscopic surgery and robotic surgery for removal of the prostate in men with localised prostate cancer.

Ramsay

Pickard²,

Robertson³

et al. 2012

Health Technol Assess

171

166

View full text Add to dashboard Cite

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“…4 The reasons for this rapid dissemination are unclear. No randomized trials and few comparative outcomes studies of RALRP versus ORRP are available, and those are largely single-center studies [5][6][7][8][9] with limited generalizability. RALRP is more expensive 10, 11 and appears to have a long learning curve to achieve optimal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Adverse Effects of Robotic-Assisted Laparoscopic Versus Open Retropubic Radical Prostatectomy Among a Nationwide Random Sample of Medicare-Age Men

Barry

Gallagher

Skinner

et al. 2012

JCO

157

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A B S T R A C T PurposeRobotic-assisted laparoscopic radical prostatectomy is eclipsing open radical prostatectomy among men with clinically localized prostate cancer. The objective of this study was to compare the risks of problems with continence and sexual function following these procedures among Medicare-age men. Patients and MethodsA population-based random sample was drawn from the 20% Medicare claims files for August 1, 2008, through December 31, 2008. Participants had hospital and physician claims for radical prostatectomy and diagnostic codes for prostate cancer and reported undergoing either a robotic or open surgery. They received a mail survey that included self-ratings of problems with continence and sexual function a median of 14 months postoperatively. ResultsCompleted surveys were obtained from 685 (86%) of 797 eligible participants, and 406 and 220 patients reported having had robotic or open surgery, respectively. Overall, 189 (31.1%; 95% CI, 27.5% to 34.8%) of 607 men reported having a moderate or big problem with continence, and 522 (88.0%; 95% CI, 85.4% to 90.6%) of 593 men reported having a moderate or big problem with sexual function. In logistic regression models predicting the log odds of a moderate or big problem with postoperative continence and adjusting for age and educational level, robotic prostatectomy was associated with a nonsignificant trend toward greater problems with continence (odds ratio [OR] 1.41; 95% CI, 0.97 to 2.05). Robotic prostatectomy was not associated with greater problems with sexual function (OR, 0.87; 95% CI, 0.51 to 1.49). ConclusionRisks of problems with continence and sexual function are high after both procedures. Medicareage men should not expect fewer adverse effects following robotic prostatectomy.

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“…However, a most recent non-randomized observational study reported that RARP had a lower PSM rate than the open approach, and postoperative adjuvant therapies including radiotherapy, chemotherapy, or androgen deprivation therapy seemed less likely to be accepted by patients who received RARP as compared with those who received ORP (OR=0.59, 95% CI=0.39-0.88, P=0.010) [28]. On the contrary, Williams et al [29] reported that the PSM rate in …”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Radical Prostatectomy vs. Open Retropubic Radical Prostatectomy for Prostate Cancer: A Systematic Review and Meta-analysis

et al. 2014

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Open retropubic radical prostatectomy (ORP) remains the "gold standard" for surgical treatment of clinically localized prostate cancer (PCa). Robot-assisted radical prostatectomy (RARP) is a robotic surgery used worldwide. The aim of this study is to collect the data available in the literature on RARP and ORP, and further evaluate the overall safety and efficacy of RARP vs. ORP for the treatment of clinically localized PCa. A literature search was performed using electronic databases between January 2009 and October 2013. Clinical data such as operation duration, transfusion rate, positive surgical margins (PSM), nerve sparing, 3-and 12-month urinary continence, and potency were pooled to carry out metaanalysis. Six studies were enrolled for this meta-analysis. The operation duration of RARP group was longer than that of ORP group (weighted mean difference=64.84). There was no statistically significant difference in the transfusion rate, PSM rate, and between RARP and ORP (transfusion rate, OR=0.30; PSM rate, OR=0.94). No significant difference was seen in 3-and 12-month urinary continence recovery (3 months, OR= 1.32; 12 months, OR=1.30). There was a statistically significant difference in potency between the 3-and 12-month groups (3 months, OR=2.80; 12 months, OR=1.70). RARP is a safe and feasible surgical technique for the treatment of clinically localized PCa owing to the advantages of fewer perioperative complications and quicker patency recovery.Keywords Robot-assisted radical prostatectomy . Open retropubic radical prostatectomy . Prostate cancer Abbreviations PCaProstate cancer RP Radical prostatectomy ORP Open retropubic radical prostatectomy RRP Retropubic radical prostatectomy RARP Robot-assisted radical prostatectomy RALP Robot-assisted laparoscopic prostatectomy PSA Prostate-specific antigen NOS Newcastle-Ottawa Scale Xiu-wu Pan and Xin-ming Cui contributed equally to this work.

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Radical Retropubic Prostatectomy and Robotic-assisted Laparoscopic Prostatectomy: Likelihood of Positive Surgical Margin(s)

Cited by 68 publications

References 28 publications

Systematic review and economic modelling of the relative clinical benefit and cost-effectiveness of laparoscopic surgery and robotic surgery for removal of the prostate in men with localised prostate cancer.

Systematic review and economic modelling of the relative clinical benefit and cost-effectiveness of laparoscopic surgery and robotic surgery for removal of the prostate in men with localised prostate cancer.

Adverse Effects of Robotic-Assisted Laparoscopic Versus Open Retropubic Radical Prostatectomy Among a Nationwide Random Sample of Medicare-Age Men

Robot-Assisted Radical Prostatectomy vs. Open Retropubic Radical Prostatectomy for Prostate Cancer: A Systematic Review and Meta-analysis

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