Prospective Multicenter Comparison of Open and Robotic Radical Prostatectomy : The PROST-QA/RP2 Consortium
PURPOSE: Our goal was to evaluate the comparative effectiveness of robot-assisted laparoscopic prostatectomy (RALP) and open radical prostatectomy (ORP) in a multicenter study.
MATERIALS AND METHODS: We evaluated men with localized prostate cancer at 11 high-volume academic medical centers in the United States from the PROST-QA (2003-2006) and the PROST-QA/RP2 cohorts (2010-2013) with a pre-specified goal of comparing RALP (549) and ORP (545). We measured longitudinal patient-reported health-related quality of life (HRQOL) at pre-treatment and at 2, 6, 12, and 24 months, and pathological and perioperative outcomes/complications.
RESULTS: Demographics, cancer characteristics, and margin status were similar between surgical approaches. ORP subjects were more likely to undergo lymphadenectomy (89% vs 47%; p <0.01) and nerve sparing (94% vs 89%; p <0.01). RALP vs ORP subjects experienced less mean intraoperative blood loss (192 vs 805 mL; p <0.01), shorter mean hospital stay (1.6 vs 2.1 days; p <0.01), and fewer blood transfusions (1% vs 4%; p <0.01), wound infections (2% vs 4%; p=0.02), other infections (1% vs 4%; p <0.01), deep venous thromboses (0.5% vs 2%; p=0.04), and bladder neck contractures requiring dilation (1.6% vs 8.3%; p <0.01). RALP subjects reported less pain (p=0.04), less activity interference (p <0.01) and higher incision satisfaction (p <0.01). Surgical approach (RALP vs ORP) was not a significant predictor of longitudinal HRQOL change in any HRQOL domain.
CONCLUSIONS: In high-volume academic centers, RALP and ORP patients may expect similar long-term HRQOL outcomes. Overall, RALP patients have less pain, shorter hospital stays, and fewer post-surgical complications such as blood transfusions, infections, deep venous thromboses, and bladder neck contractures.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:207 |
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| Enthalten in: |
The Journal of urology - 207(2022), 1 vom: 01. Jan., Seite 127-136 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Chang, Peter [VerfasserIn] |
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| Links: |
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| Themen: |
Comparative Study |
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| Anmerkungen: |
Date Completed 20.01.2022 Date Revised 02.01.2023 published: Print-Electronic ClinicalTrials.gov: NCT01325506 Citation Status MEDLINE |
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| doi: |
10.1097/JU.0000000000002176 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM329764713 |
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| 100 | 1 | |a Chang, Peter |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prospective Multicenter Comparison of Open and Robotic Radical Prostatectomy |b The PROST-QA/RP2 Consortium |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 20.01.2022 | ||
| 500 | |a Date Revised 02.01.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT01325506 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: Our goal was to evaluate the comparative effectiveness of robot-assisted laparoscopic prostatectomy (RALP) and open radical prostatectomy (ORP) in a multicenter study | ||
| 520 | |a MATERIALS AND METHODS: We evaluated men with localized prostate cancer at 11 high-volume academic medical centers in the United States from the PROST-QA (2003-2006) and the PROST-QA/RP2 cohorts (2010-2013) with a pre-specified goal of comparing RALP (549) and ORP (545). We measured longitudinal patient-reported health-related quality of life (HRQOL) at pre-treatment and at 2, 6, 12, and 24 months, and pathological and perioperative outcomes/complications | ||
| 520 | |a RESULTS: Demographics, cancer characteristics, and margin status were similar between surgical approaches. ORP subjects were more likely to undergo lymphadenectomy (89% vs 47%; p <0.01) and nerve sparing (94% vs 89%; p <0.01). RALP vs ORP subjects experienced less mean intraoperative blood loss (192 vs 805 mL; p <0.01), shorter mean hospital stay (1.6 vs 2.1 days; p <0.01), and fewer blood transfusions (1% vs 4%; p <0.01), wound infections (2% vs 4%; p=0.02), other infections (1% vs 4%; p <0.01), deep venous thromboses (0.5% vs 2%; p=0.04), and bladder neck contractures requiring dilation (1.6% vs 8.3%; p <0.01). RALP subjects reported less pain (p=0.04), less activity interference (p <0.01) and higher incision satisfaction (p <0.01). Surgical approach (RALP vs ORP) was not a significant predictor of longitudinal HRQOL change in any HRQOL domain | ||
| 520 | |a CONCLUSIONS: In high-volume academic centers, RALP and ORP patients may expect similar long-term HRQOL outcomes. Overall, RALP patients have less pain, shorter hospital stays, and fewer post-surgical complications such as blood transfusions, infections, deep venous thromboses, and bladder neck contractures | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a prostatectomy | |
| 650 | 4 | |a quality of life | |
| 650 | 4 | |a robotic surgical procedures | |
| 700 | 1 | |a Wagner, Andrew A |e verfasserin |4 aut | |
| 700 | 1 | |a Regan, Meredith M |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Joseph A |e verfasserin |4 aut | |
| 700 | 1 | |a Saigal, Christopher S |e verfasserin |4 aut | |
| 700 | 1 | |a Litwin, Mark S |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Jim C |e verfasserin |4 aut | |
| 700 | 1 | |a Cooperberg, Matthew R |e verfasserin |4 aut | |
| 700 | 1 | |a Carroll, Peter R |e verfasserin |4 aut | |
| 700 | 1 | |a Klein, Eric A |e verfasserin |4 aut | |
| 700 | 1 | |a Kibel, Adam S |e verfasserin |4 aut | |
| 700 | 1 | |a Andriole, Gerald L |e verfasserin |4 aut | |
| 700 | 1 | |a Han, Misop |e verfasserin |4 aut | |
| 700 | 1 | |a Partin, Alan W |e verfasserin |4 aut | |
| 700 | 1 | |a Wood, David P |e verfasserin |4 aut | |
| 700 | 1 | |a Crociani, Catrina M |e verfasserin |4 aut | |
| 700 | 1 | |a Greenfield, Thomas K |e verfasserin |4 aut | |
| 700 | 1 | |a Patil, Dattatraya |e verfasserin |4 aut | |
| 700 | 1 | |a Hembroff, Larry A |e verfasserin |4 aut | |
| 700 | 1 | |a Davis, Kyle |e verfasserin |4 aut | |
| 700 | 1 | |a Stork, Linda |e verfasserin |4 aut | |
| 700 | 1 | |a Spratt, Daniel E |e verfasserin |4 aut | |
| 700 | 1 | |a Wei, John T |e verfasserin |4 aut | |
| 700 | 1 | |a Sanda, Martin G |e verfasserin |4 aut | |
| 700 | 0 | |a PROST-QA/RP2 Consortium |e verfasserin |4 aut | |
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