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67th Annual Meeting Abstracts

Impact Of Surgical Technique (Open Vs. Laparoscopic Vs. Robotic-assisted) On Pathological And Biochemical Outcomes Following Radical Prostatectomy: An Analysis Utilizing Propensity Score Matching.
*Ahmed Magheli, Christian Pavlovich, *Li-Ming Su, Thomas J. Guzzo, *George Netto, *Elizabeth Humphreys, Misop Han, Alan W. Partin, Mark L. Gonzalgo
Johns Hopkins University, Baltimore, MD

Introduction: No study to date has compared outcomes of retropubic (RRP), laparoscopic (LRP), and robotic assisted radical prostatectomy (RARP) in a matched fashion. We investigated a single institution experience with RRP, LRP, and RARP with respect to pathological and biochemical outcomes.
Materials & Methods: A group of 522 consecutive patients who underwent RARP between 2003 and 2008 were matched by propensity scoring on the basis of patient age, clinical stage, biopsy Gleason score, race, and preoperative PSA to an equal number of patients who underwent LRP and RRP at our institution. Pathological and biochemical outcomes of the three cohorts were examined.
Results: Overall positive surgical margins were lower among patients who underwent RRP (14.4%) and LRP (13.0%) compared to patients who underwent RARP (19.5%) (p = 0.010). In multivariate logistic regression analysis, surgical technique (p = 0.007), biopsy Gleason score (p < 0.001) and preoperative PSA (p < 0.001) were predictors of positive surgical margins. Kaplan-Meier analysis did not show any statistically significant differences with respect to biochemical recurrence for the three surgical groups.
Conclusions: RRP, LRP, and RARP represent effective surgical approaches for the treatment for clinically localized prostate cancer. A higher positive SM rate was observed for the RARP group compared to RRP and LRP, however, there was no difference with respect to biochemical recurrence-free survival between groups. Further prospective studies are warranted to determine whether any particular technique is superior with regard to long term clinical outcomes.

 

 

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