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

Authors
 Kyo Chul Koo  ;  Patrick Tuliao  ;  Young Eun Yoon  ;  Byung Ha Chung  ;  Sung Joon Hong  ;  Seung Choul Yang  ;  Koon Ho Rha 
Citation
 INTERNATIONAL JOURNAL OF UROLOGY, Vol.21(8) : 781-785, 2014 
Journal Title
 INTERNATIONAL JOURNAL OF UROLOGY 
ISSN
 0919-8172 
Issue Date
2014
MeSH
Aged ; Follow-Up Studies ; Humans ; Laparoscopy* ; Male ; Middle Aged ; Propensity Score ; Prostatectomy/methods* ; Prostatic Neoplasms/surgery* ; Republic of Korea ; Robotics ; Treatment Outcome
Keywords
prostate cancer ; prostatectomy ; robotics ; treatment outcome
Abstract
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.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/iju.12447/abstract
DOI
10.1111/iju.12447
Appears in Collections:
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
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99684
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