Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: 24-month outcomes from a randomised controlled study

Coughlin, Geoff; Yaxley, John; Chambers, Suzanne K.; Occhipinti, Stefano; Samaratunga, Hemamali; Zajdlewicz, Leah; Teloken, Patrick; Dunglison, Nigel; Williams, Scott; Lavin, Martin F.; Gardiner, Robert A.

doi:10.1016/s1470-2045(18)30357-7

Cited by 355 publications

(308 citation statements)

References 36 publications

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“…Up to 28% of patients were distressed prior to their surgery for prostate cancer. The proportion of patients indicating psychological distress remained stable across time with 21% distressed 24 months later (Table ) . The pattern of domain‐specific QoL scores across time is presented in Tables and .…”

Section: Resultsmentioning

confidence: 89%

“…These data are from a randomised controlled trial comparing open radical retropubic prostatectomy with robot‐assisted laparoscopic prostatectomy, with trial outcome data reported elsewhere . Patients for this study were managed at the Royal Brisbane & Women's Hospital (RBWH) with referrals to the public clinics from general practice and the private practices of urologists in SE Queensland in Australia.…”

Section: Methodsmentioning

confidence: 99%

“…Further, research to date is limited by being largely cross‐sectional such that actual trajectories of distress over time are not well described nor understood. In our randomised controlled trial comparing outcomes for men with localised prostate cancer treated by either robotic or open prostatectomy followed men from baseline to 24 months, we found no long‐term differences in psychological outcomes on the basis of surgical approach . However, there was evidence of wide variation in psychological outcomes across men within groups, and such heterogeneity at the individual level was not addressed by statistical analyses that compared groups.…”

Section: Introductionmentioning

confidence: 99%

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A prospective study of psychological distress after prostate cancer surgery

et al. 2019

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Background Men treated for prostate cancer experience heightened psychological distress and have an increased risk of suicide. Management of this distress and risk is crucial for quality urological care. Objective To identify risk indicators for poorer trajectories of psychological adjustment and health‐related quality of life (QoL) after surgery for localised prostate cancer. Design, Setting, and Participants Patients were newly diagnosed with localised prostate cancer scheduled for surgical treatment. Patients were assessed at baseline (pre‐surgery) and 6 weeks, 3 months, 6 months, 12 months, and 24 months post–surgery. Measurements Assessment measures included sociodemographics, domain‐specific and health‐related QoL, and psychological distress. Mixed effects regression models were used to analyse the data. Results and Limitations A total of 233 patients provided data for this analysis (Mage = 60 years, standard deviation [SD] = 4.02; MPSA = 7.37 ng/mL). At baseline, the prevalence of high psychological distress was 28% reducing to 21% at 24 months. Before treatment, younger age, more comorbidities, and worse bowel function were related to greater psychological distress; and younger age and better urinary, sexual, and bowel function were related to better health‐related QoL. By contrast, for changes over time, only bowel function was important with better bowel function predicting decreasing psychological distress for men. Conclusions Regular distress screening is indicated over the 24 months after surgery for localised prostate cancer. Care pathways for men with prostate cancer need also to respond to age‐specific concerns and health problems associated with comorbidities in aging men. Focussed symptom control for bowel bother should be a priority.

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Section: Resultsmentioning

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A prospective study of psychological distress after prostate cancer surgery

et al. 2019

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“…Comprehensive meta-analyses [3][4][5] of retrospective institutional series, as well as the only available randomized controlled trail [6,7], did not provide definitive data on the superiority of one surgical approach over the others. On the whole, these studies have been criticized because of arbitrary outcome definitions, lack of validated outcome measures, short follow-up time, disparities in surgeon's experience and inclusion of series from single surgeons or high volume institutions [8].…”

Section: Introductionmentioning

confidence: 99%

Impact of Surgical Approach on Patient-Reported Outcomes after Radical Prostatectomy: A Propensity Score-Weighted Analysis from a Multicenter, Prospective, Observational Study (The Pros-IT CNR Study)

et al. 2019

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Background: To report health-related quality of life outcomes as assessed by validated patient-reported outcome measures (PROMs) after radical prostatectomy (RP). Methods: This study analyzed patients treated with RP within The PROState cancer monitoring in Italy, from the National Research Council (Pros-IT CNR). Italian versions of Short-Form Heath Survey and university of California los Angeles-prostate cancer index questionnaires were administered. PROMs were physical composite scores, mental composite scores and urinary, bowel, sexual functions and bothers (UF/B, BF/B, SF/B). Baseline unbalances were controlled with propensity scores and stabilized inverse weights; differences in PROMs between different RP approaches were estimated by mixed models. Results: Of 541 patients treated with RP, 115 (21%) received open RP (ORP), 90 (17%) laparoscopic RP (LRP) and 336 (61%) robot-assisted RP (RARP). At head-to-head comparisons, RARP showed higher 12-month UF vs. LRP (interaction treatment * time p = 0.03) and 6-month SF vs. ORP (p < 0.001). At 12-month from surgery, 67, 73 and 79% of patients used no pad for urinary loss in ORP, LRP and RARP respectively (no differences for each comparison). Conversely, 16, 27 and 40% of patients declared erections firm enough for sexual intercourse in ORP, LRP and RARP respectively (only significant difference for ORP vs. RARP, p = 0.0004). Conclusions: Different RP approaches lead to significant variations in urinary and sexual PROMs, with a general trend in favour of RARP. However, their clinical significance seems limited.

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“…The treatment armamentarium for localized and locally advanced prostate cancer is variable, and surgical techniques have evolved to render better patient outcomes. Minimally invasive surgery (MIS) is purported to provide superior results with regards to patient recovery along with equivalent oncological control compared with open surgery . In tandem with the increase in the number of robot‐assisted radical prostatectomy (RARP) performed, interest in health‐related quality of life (HRQOL) among prostate cancer patients has also peaked.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal study on the impact of urinary continence and sexual function on health‐related quality of life among Japanese men after robot‐assisted radical prostatectomy

Ngoo

Honda

Kimura

et al. 2019

Robotics Computer Surgery

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Background The aim of this study is to investigate the impact of robotic‐assisted radical prostatectomy (RARP) on the health‐related quality of life (HRQOL). Methods We prospectively reviewed HRQOL parameters using Short‐Form Health Survey, patient self‐reporting of urinary incontinence and International Index of Erectile Function, among patients who underwent RARP between 2010 and 2016. Results Among 249 men studied, all had significantly worse HRQOL domain scores at 1 month post operatively but 24 months after surgery, all domains reached or surpassed their baseline values. Only Bodily Pain, General Health, Role‐Emotional, Mental Health domains, and Mental Health Composite were significantly improved. Improvement in urinary continence was mirrored by improvements in both Mental and Physical Component Scores. Conclusions Within a 2‐year post‐operative period, men who underwent RARP had regained their overall quality of life. The recovery of urinary continence significantly impacted the mental, physical, emotional, and social well‐being of those patients.

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Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: 24-month outcomes from a randomised controlled study

Cited by 355 publications

References 36 publications

A prospective study of psychological distress after prostate cancer surgery

A prospective study of psychological distress after prostate cancer surgery

Impact of Surgical Approach on Patient-Reported Outcomes after Radical Prostatectomy: A Propensity Score-Weighted Analysis from a Multicenter, Prospective, Observational Study (The Pros-IT CNR Study)

Longitudinal study on the impact of urinary continence and sexual function on health‐related quality of life among Japanese men after robot‐assisted radical prostatectomy

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