Impact of a robotic surgical system on treatment choice for men with clinically organ-confined prostate cancer

Kobayashi, Takashi; Kanao, Kent; Araki, Motoo; Terada, Naoki; Kobayashi, Yasuyuki; Sawada, Atsuro; Inoue, Takahiro; Ebara, Shin; Watanabe, Toyohiko; Kamba, Tomomi; Sumitomo, Makoto; Nasu, Yasutomo; Ogawa, Osamu

doi:10.1007/s10147-017-1203-1

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…Concerning clinical practice, a retrospective multicenter study was carried out by Kobayashi et al [ 18 ] in Japan on 718 patients who underwent RP surgery between 2011 and 2013. Their results revealed an increase rate of 70% for RP after the introduction of a RPl, increasing from 127 cases in 2011 to 221 cases in 2013 ( p < 0.0001).…”

Section: Discussionmentioning

confidence: 99%

Impact of Robotic Technologies on Prostate Cancer Patients’ Choice for Radical Treatment

Esperto

Cacciatore

Tedesco

et al. 2023

JPM

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Prostate cancer (PCa) surgery has a strong impact on men’s social and sexual lives. For this reason, many patients ask for robotic surgery. To assess the rate of lost patients due to the lack of a robotic platform (RPl) at our center, we retrospectively selected 577 patients who underwent prostate biopsy between 2020 and 2021 who were eligible for radical prostatectomy (RP) (ISUP ≥ 2; age ≤ 70 yr). Patients eligible for surgery who decided to be operated received a phone call interview asking the reason for their choice. Overall, 230 patients (31.7%) underwent laparoscopic-assisted radical prostatectomy (LaRP) at our center, while 494 patients (68.3%) were not treated in our hospital. Finally, 347 patients were included: 87 patients (25.1%) underwent radiotherapy; 59 patients (17%) were already under another urologist’s care; 113 patients (32.5%) underwent robotic surgery elsewhere; and 88 patients (25.4%) followed the suggestion of friends or relatives based on their surgical experience. Despite no surgical technique for RP having shown superiority in terms of oncological or functional outcomes, patients eligible for PCa treatment decided to be operated on elsewhere because of the lack of an RPl. Our results show how the presence of an RPl may increase the case volume of RP by 49% at our center.

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Section: Discussionmentioning

confidence: 99%

Impact of Robotic Technologies on Prostate Cancer Patients’ Choice for Radical Treatment

Esperto

Cacciatore

Tedesco

et al. 2023

JPM

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“…In fact, a multicenter study conducted at three academic hospitals found that the number of referrals from other hospitals increased after the introduction of RARP. 32 , 33 ) Finally, preoperative white blood cell counts have been reported to be predictive of the postoperative LOS in patients with prostate cancer. 7 ) Whether other preoperative biochemical test results influence the LOS is unknown, and the DPC database does not include these data.…”

Section: Discussionmentioning

confidence: 99%

Effect of Early Postoperative Rehabilitation on Length of Hospital Stay after Robot-assisted Radical Prostatectomy

Higuchi,

Matsugaki,

Tomisaki

et al. 2023

PRM

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Objectives : This study assessed how early postoperative rehabilitation interventions affected the duration of hospital stay in patients with prostate cancer who had radical prostatectomy with robotic assistance. Methods : From the Japanese Diagnosis Procedure Combination database, we extracted case data for patients discharged between April 2014 and March 2020. Patients were recognized by code C61 from the International Classification of Diseases, 10th Edition. We ran a multilevel linear regression analysis to investigate the impact of early rehabilitation on the duration of hospital stay. Results : There were 2151 participants in the trial. In patients with prostate cancer who had resection utilizing robotic-assisted devices, early rehabilitation was related to a substantial decrease in duration of hospital stay (coefficient, −0.86; 95% CI, −1.64 to −0.07; P=0.032). Conclusions : Early postoperative rehabilitation may contribute to shorter hospital stays in patients with prostate cancer at high risk of both postoperative complications and a decline in their ability to perform activities of daily living.

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“…6 The increase was mainly induced by replacement of RT or ADT, not by expectant management that could cause overtreatment. 7 The superiority of RARP regarding complications and blood loss might be indisputable, while oncological and functional outcomes have been controversial. [8][9][10] The Retzius sparing technique is one of the techniques that has been superior to ORP in terms of earlier return to continence, while there are some reports pointing out the high rate of positive surgical margin by this technique.…”

Section: Discussionmentioning

confidence: 99%

“…RARP rapidly replaced ORP after its introduction and was preferentially selected by both patients and surgeons when compared with other treatment modalities such as RT and AS/WW 6 . The increase was mainly induced by replacement of RT or ADT, not by expectant management that could cause overtreatment 7 . The superiority of RARP regarding complications and blood loss might be indisputable, while oncological and functional outcomes have been controversial 8–10 .…”

Section: Discussionmentioning

confidence: 99%

Trends in primary treatment for localized prostate cancer according to the availability of treatment modalities and the impact of introducing robotic surgery

et al. 2022

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Objectives We aimed to investigate the effect of available treatment modalities on primary treatment selection in patients with localized prostate cancer and that of introducing robotic surgery. Methods We retrospectively studied 12 061 patients diagnosed with localized prostate cancer between 2004 and 2018 from 21 institutions. These institutions were divided into five groups according to the availability of surgery and radiotherapy. Differences in primary treatment selection between the institutions were investigated, and the predictive factors involved in the selection were explored. Results Surgery, radiotherapy, androgen deprivation therapy, and active surveillance/watchful waiting were selected as primary treatment in 4115, 3621, 3188, and 821 patients, respectively, while the remaining 316 patients selected other modalities. The number of patients, particularly young patients, was much higher in institutions with both surgery and radiotherapy. With the introduction of robotic surgery, open radical prostatectomy has decreased, and robotic surgery made up approximately 70% of all prostatectomies. Institutions with both surgery and radiotherapy tended to treat patients with very low or low risk by surgery or radiotherapy, while institutions without surgery and radiotherapy tended to select active surveillance or watchful waiting. Multivariate analysis revealed that primary treatment selection for prostate cancer was affected not only by clinical factors, but also by the available modalities in each institution. Conclusions Differences in available treatment modalities affect the selection of primary treatment for localized prostate cancer. Introduction of robotic surgery also has a strong influence on the number of patients in each institution.

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Impact of a robotic surgical system on treatment choice for men with clinically organ-confined prostate cancer

Cited by 4 publications

References 22 publications

Impact of Robotic Technologies on Prostate Cancer Patients’ Choice for Radical Treatment

Impact of Robotic Technologies on Prostate Cancer Patients’ Choice for Radical Treatment

Effect of Early Postoperative Rehabilitation on Length of Hospital Stay after Robot-assisted Radical Prostatectomy

Trends in primary treatment for localized prostate cancer according to the availability of treatment modalities and the impact of introducing robotic surgery

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