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Robot-assisted radical prostatectomy in the Korean population: A 5-year propensity-score matched comparative analysis versus open radical prostatectomy

 Kyo Chul Koo  ;  Patrick Tuliao  ;  Young Eun Yoon  ;  Byung Ha Chung  ;  Sung Joon Hong  ;  Seung Choul Yang  ;  Koon Ho Rha 
 INTERNATIONAL JOURNAL OF UROLOGY, Vol.21(8) : 781-785, 2014 
Journal Title
Issue Date
Aged ; Follow-Up Studies ; Humans ; Laparoscopy* ; Male ; Middle Aged ; Propensity Score ; Prostatectomy/methods* ; Prostatic Neoplasms/surgery* ; Republic of Korea ; Robotics ; Treatment Outcome
prostate cancer ; prostatectomy ; robotics ; treatment outcome
OBJECTIVES: To compare the oncological outcomes of robot-assisted laparoscopic radical prostatectomy with those of open radical prostatectomy in contemporary Korean prostate cancer patients. METHODS: From a group of 1172 patients consisting of 592 (50.5%) robot-assisted laparoscopic radical prostatectomy and 580 (49.5%) open radical prostatectomy cases carried out between 1992 and 2008, 175 robot-assisted laparoscopic radical prostatectomy cases were matched with an equal number of open radical prostatectomy cases by propensity scoring based on patient age, preoperative prostate-specific antigen, biopsy Gleason score and clinical tumor stage. Competing-risks survival analyses were used to evaluate oncological outcomes, including rates of positive surgical margin, biochemical-recurrence, adjuvant therapy, cancer-specific survival, overall survival and metastasis-free survival during the mean follow up of 58.4 months. RESULTS: Positive surgical margin rates were comparable between robot-assisted laparoscopic radical prostatectomy and open radical prostatectomy cohorts (19.4% vs 21.8%), with comparable rates for all pathological stages and risk subgroups. Positive surgical margin rates according to location were comparable, with the apical margin being the most common location. Robot-assisted laparoscopic radical prostatectomy recovered higher lymph node yields compared with open radical prostatectomy (12.5 vs 3.8; P < 0.001). The robot-assisted laparoscopic radical prostatectomy and the open radical prostatectomy groups showed equal oncological outcomes regarding 5-year biochemical recurrence-free survival (log-rank P = 0.651), metastasis-free survival (log-rank P = 0.876), cancer-specific survival (log-rank P = 0.076) and overall survival (log-rank P = 0.648), respectively. Between groups, there was no difference in the rate of adjuvant therapy, time to first adjuvant therapy failure or in the rate of subsequent secondary treatment. CONCLUSIONS: Robot-assisted laparoscopic radical prostatectomy represents an effective surgical approach for the treatment of prostate cancer in the Korean population, as it provides equivalent oncological outcomes to open radical prostatectomy.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Yang, Seung Choul(양승철)
Yoon, Young Eun(윤영은)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Tuliao, Patrick(툴리아오패트릭)
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
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