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• W2034172393 abstract "You have accessJournal of UrologyProstate Cancer: Localized V1 Apr 2015MP62-04 COMPARATIVE EFFECTIVENESS OF ROBOT ASSISTED VS. OPEN RADICAL PROSTATECTOMY IN INTERMEDIATE AND HIGH RISK PATIENTS Giorgio Gandaglia, Nazareno Suardi, Nicola Fossati, Alessandro Larcher, Elena Farina, Marta Picozzi, Irene Locatelli, Andrea Gallina, Vincenzo Mirone, Giorgio Guazzoni, Francesco Montorsi, and Alberto Briganti Giorgio GandagliaGiorgio Gandaglia More articles by this author , Nazareno SuardiNazareno Suardi More articles by this author , Nicola FossatiNicola Fossati More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , Elena FarinaElena Farina More articles by this author , Marta PicozziMarta Picozzi More articles by this author , Irene LocatelliIrene Locatelli More articles by this author , Andrea GallinaAndrea Gallina More articles by this author , Vincenzo MironeVincenzo Mirone More articles by this author , Giorgio GuazzoniGiorgio Guazzoni More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2378AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Evidence is scarce regarding the comparison of perioperative, functional, and oncologic outcomes between open (ORP) and robot-assisted radical prostatectomy (RARP) in intermediate and high-risk Prostate cancer (PCa). We hypothesized that technical advantages associated with minimally invasive surgery might lead to superior outcomes. METHODS Overall, 1,975 patients with intermediate and high-risk PCa according to D'Amico criteria treated between 2008 and 2014 were identified. Erectile function (EF) recovery was defined as an International Index of Erectile Function EF domain (IIEF-EF) ≥22. Urinary continence (UC) was defined as being completely pad free over a 24-hour period. Multivariable logistic and Cox regression models were used to test the impact of RARP on perioperative and functional outcomes after accounting for confounders. Multivariable Cox regression analyses the impact of RARP on the risk of BCR (defined as two consecutive PSA ≥0.2ng/ml) in patients with high-risk disease (n=607). To decrease the effect of unmeasured confounders, these analyses were repeated in a propensity score matched cohort. RESULTS Mean age was 64.8 years. Median follow up was 27 months. Overall, 1,162 (58.8%) and 813 (41.2%) patients were treated with ORP and RARP, respectively. Patients treated with RARP had lower median blood loss (250 vs. 800 ml, P<0.001), transfusions (4.6 vs. 14.8%, P<0.001), and length of stay (6 vs. 8 days, P<0.001). No differences were observed with regards to Clavien III-V complications (5.1 vs. 6.2%, P=0.2). In logistic regression analyses, RARP was associated with lower odds of transfusions and prolonged length of stay (P<0.001). Patients treated with RARP had higher 3-year UC (81.1 vs. 68.8%; P<0.001) and EF (66.3 vs. 49.5%; P=0.01) recovery rates. In multivariable analyses, RARP was associated with higher probability of UC (P<0.001) and EF (P=0.02) recovery. When evaluating high-risk patients, no differences were observed between ORP and RARP with regards to 3-year BCR-free survival rates (P=0.6). This was confirmed in multivariable regression analyses and after propensity score matching (all P>0.05). CONCLUSIONS RARP is associated with better perioperative and functional outcomes in intermediate and high-risk PCa. Short-term oncologic outcomes are comparable between ORP and RARP. The potential benefits of RARP should be taken into account provided a need for longer cancer control assessments. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e781 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Giorgio Gandaglia More articles by this author Nazareno Suardi More articles by this author Nicola Fossati More articles by this author Alessandro Larcher More articles by this author Elena Farina More articles by this author Marta Picozzi More articles by this author Irene Locatelli More articles by this author Andrea Gallina More articles by this author Vincenzo Mirone More articles by this author Giorgio Guazzoni More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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