Robot-assisted Radical Prostatectomy Has Lower Biochemical Recurrence Than Laparoscopic Radical Prostatectomy: Systematic Review and Meta-analysis

Overview

Journal Investig Clin Urol

Specialty Urology

Date 2017 May 9

PMID 28480340

Citations 16

Authors

Seon Heui Lee

Hyun Ju Seo

Na Rae Lee

Soo Kyung Son

Dae Keun Kim

Koon Ho Rha

Affiliations

Soon will be listed here.

Abstract

Purpose: To assess the effectiveness and safety of robot-assisted radical prostatectomy (RARP) versus laparoscopic radical prostatectomy (LRP) in the treatment of prostate cancer.

Materials And Methods: Existing systematic reviews were updated to investigate the effectiveness and safety of RARP. Electronic databases, including Ovid MEDLINE, Ovid Embase, the Cochrane Library, KoreaMed, Kmbase, and others, were searched through July 2014. The quality of the selected systematic reviews was assessed by using the revised assessment of multiple systematic reviews (R-Amstar) and the Cochrane Risk of Bias tool. Meta-analysis was performed by using Revman 5.2 (Cochrane Community) and Comprehensive Meta-Analysis 2.0 (CMA; Biostat). Cochrane Q and I2 statistics were used to assess heterogeneity.

Results: Two systematic reviews and 16 additional studies were selected from a search performed of existing systematic reviews. These included 2 randomized controlled clinical trials and 28 nonrandomized comparative studies. The risk of complications, such as injury to organs by the Clavien-Dindo classification, was lower with RARP than with LRP (relative risk [RR], 0.44; 95% confidence interval [CI], 1.23-0.85; p=0.01). The risk of urinary incontinence was lower (RR, 0.43; 95% CI, 0.31-0.60; p<0.000001) and the potency rate was significantly higher with RARP than with LRP (RR, 1.38; 95% CI, 1.11-1.70; I=78%; p=0.003). Regarding positive surgical margins, no significant difference in risk between the 2 groups was observed; however, the biochemical recurrence rate was lower after RARP than after LRP (RR, 0.59; 95% CI, 0.48-0.73; I=21%; p<0.00001).

Conclusions: RARP appears to be a safe and effective technique compared with LRP with a lower complication rate, better potency, a higher continence rate, and a decreased rate of biochemical recurrence.

Citing Articles

Economic Evaluation of Robotic-assisted Radical Prostatectomy: A Systematic Review and Meta-analysis.

Bejrananda T, Khaing W, Veettil S, Thongseiratch T, Chaiyakunapruk N Eur Urol Open Sci. 2025; 72:17-28.

PMID: 39996029 PMC: 11849673. DOI: 10.1016/j.euros.2025.01.011.

A comprehensive examination and meta-analysis evaluating perioperative, oncological, and functional results of robotic-assisted radical prostatectomy (RARP) in comparison to three-dimensional laparoscopic radical prostatectomy (3D LRP).

Wang C, Pang C, Qin J, Chen C, Huang H, Li H J Robot Surg. 2024; 18(1):356.

PMID: 39347856 DOI: 10.1007/s11701-024-02110-6.

Transversal approach via a bladder neck and prostate combined longitudinal incision versus standard approach of robotic-assisted radical prostatectomy for localized prostate cancer: a retrospective analysis.

Shen Z, Yao C, Bai Y, Wang Y, Zhang Q BMC Cancer. 2024; 24(1):313.

PMID: 38448829 PMC: 10916070. DOI: 10.1186/s12885-024-12015-0.

A Study of 57 Patients with Prostate Cancer to Compare Outcomes of Estimated Blood Loss and Postoperative Pain Between Robot-Assisted Laparoscopic Radical Prostatectomy and Standard Laparoscopic Radical Prostatectomy.

Lee D, Hwang B, Kwon J, Kim O, Hong J, Kim H Med Sci Monit. 2023; 29:e939584.

PMID: 36890716 PMC: 10012766. DOI: 10.12659/MSM.939584.

Efficacy of the transvesical approach for robotic-assisted radical prostatectomy a bladder neck and prostate combined longitudinal incision for the treatment of localized prostate cancer.

Yang Y, Wang J, Zhang D, Zhang Q Front Surg. 2023; 9:1053140.

PMID: 36684143 PMC: 9852527. DOI: 10.3389/fsurg.2022.1053140.

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