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Purpose: To evaluate outcomes among a matched cohort of prostate cancer patients
treated with radical retropubic prostatectomy (RRP) and robot assisted radical
prostatectomy (RARP).
Materials and methods: Between 2002 and 2005, 294 patients underwent RARP at our
institution. Comparison RRP patients were matched 2:1 for surgical year, age, PSA,
clinical stage, and biopsy grade (n=588). Outcomes among groups were compared.
From an oncologic standpoint, pathologic features among groups were assessed and
Kaplan-Meier estimates of PSA recurrence free survival were compared.
Results: Overall margin positivity was not significantly different between groups
(RARP, 15.6%, RRP, 17%), yet risk of apical margin was significantly less with RARP.
RARP was associated with significantly shorter hospitalization (p<0.01) and lower
incidence of blood transfusion (p < 0.01). Early complications were higher in the RARP
group (16% vs 10%, p<0.01). Among late complications, risk of bladder neck
contracture was lower with RARP (1.2%, p=0.02). Adjuvant hormonal therapy was
significantly higher in the RRP group (6.6% p<0.01). Continence at 1 year among
groups was equivalent (p=0.15). Potency at 1 year was better among RARP patients
(p=0.02). At a median followup of 1.3 years, PSA recurrence free estimates were not
significantly different (92% vs 92%, p=0.69).
Conclusions: Early complications were higher in this RARP group, but this experience
includes cases performed in the learning curve. Oncologic, quality of life, and functional
data in this study revealed encouraging results for RARP when compared to RRP.
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