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Risk of Recurrent D...
Risk of Recurrent Disease 6 Years After Open or Robotic-assisted Radical Prostatectomy in the Prospective Controlled Trial LAPPRO
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- Nyberg, Martin (author)
- Lund University,Lunds universitet,Urologisk cancerforskning, Malmö,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Urological cancer, Malmö,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital
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- Akre, O. (author)
- Karolinska Institutet,Karolinska Institute
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- Bock, David, 1976 (author)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery
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- Carlsson, Sigrid, 1982 (author)
- Karolinska Institutet,University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology,Memorial Sloan-Kettering Cancer Center
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- Carlsson, S. (author)
- Karolinska Institute
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- Hugosson, J. (author)
- University of Gothenburg,Sahlgrenska University Hospital
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- Lantz, A. (author)
- Karolinska Institutet,Karolinska Institute,Icahn School of Medicine at Mount Sinai
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- Steineck, Gunnar, 1952 (author)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för onkologi,Institute of Clinical Sciences, Department of Oncology
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- Stranne, J. (author)
- University of Gothenburg,Sahlgrenska University Hospital
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- Tyritzis, S. (author)
- Karolinska Institutet,Karolinska Institute,Hygeia Hospital
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- Wiklund, Peter (author)
- Karolinska Institutet,Karolinska Institute
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- Haglind, Eva, 1947 (author)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Sahlgrenska University Hospital
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- Bjartell, Anders (author)
- Lund University,Lunds universitet,Urologisk cancerforskning, Malmö,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Urological cancer, Malmö,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital
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(creator_code:org_t)
- Elsevier BV, 2020
- 2020
- English.
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In: European Urology Open Science. - : Elsevier BV. - 2666-1691 .- 2666-1683. ; 20, s. 54-61
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Abstract
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- Background: Conclusive evidence of superiority in oncological outcome for robotassisted laparoscopic prostatectomy (RALP) over retropubic radical prostatectomy (RRP) is lacking. Objective: To compare RALP and RRP regarding recurrent disease and to report the mortality rate 6 yr after surgery. Design, setting, and participants: A total of 4003 men with localized prostate cancer were enrolled between 2008 and 2011 in Laparoscopic Prostatectomy Robot Open (LAPPRO)- a prospective, controlled, nonrandomized trial performed at 14 Swedish centers. Outcome measurements and statistical analysis: Data were collected at visits and by patient questionnaires at 3, 12, and 24 mo, and through a structured telephone interview at 6 yr. Cause of death was retrieved from the National Cause of Death Register in Sweden. The modified Poisson regression approach was used for analyses. Results and limitations: After adjustment for patient-, tumor-, and surgeon-related confounders, no statistically significant difference was observed between RALP and RRP in biochemical recurrence rate (14 vs 16%, relative risk [RR] 0.77, 95% confidence interval [CI] 0.56-1.06) or in not cured endpoint (22% vs 23%, RR 0.82, 95% CI 0.6-1.11). Stratified by D'Amico risk group, a significant benefit for RALP existed for recurrent disease in high-risk patients (RR 0.47, 95% CI 0.26-0.86, p = 0.02). All-cause mortality was 3% (n = 96). Prostate cancer-specific mortality was 0.6% (n = 21) overall, 0.3% (n = 8) after RALP, and 1.5% (n = 13) after RRP. The nonrandomized design is a limitation. Conclusions: No significant difference was observed for cancer recurrence rate between RALP and RRP 6 yr after surgery. However, in a subgroup analysis, we found a significant benefit for RALP regarding recurrence rate in the high-risk group. Larger studies with longer follow-up are needed to make a firm conclusion and to evaluate a possible survival benefit. Patient summary: In general, the oncological outcome is comparable between robotic and open radical prostatectomy 6 yr after surgery. For high-risk patients, our findings indicate that there is an advantage for robotics, but further studies with longer follow-up time is needed to make a firm conclusion. (c) 2020 Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY-NC-ND license (http://creativecommons. org/licenses/by-nc-nd/4.0/).
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Keyword
- Prostate cancer
- Radical prostatectomy
- Robot-assisted radical
- prostatectomy
- Biochemical recurrence
- Prostate cancer-specific
- mortality
- surgical learning-curve
- biochemical recurrence
- oncologic outcomes
- cancer control
- Urology & Nephrology
- Prostate cancer-specific mortality
- Robot-assisted radical prostatectomy
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Nyberg, Martin
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Akre, O.
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Bock, David, 197 ...
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Carlsson, Sigrid ...
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Carlsson, S.
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Hugosson, J.
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Lantz, A.
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Steineck, Gunnar ...
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Stranne, J.
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Tyritzis, S.
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Wiklund, Peter
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Haglind, Eva, 19 ...
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Bjartell, Anders
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Urology and Neph ...
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European Urology ...
- By the university
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University of Gothenburg
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Lund University
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Karolinska Institutet