Results from an observational study conducted by researchers at the UCLA’s Jonsson Comprehensive Cancer Center shows that prostate cancer patients who undergo robot-assisted radical prostatectomy (RARP) or robotic-assisted prostate surgery have fewer instances of cancer cells at the edge of their surgical specimen and less need for additional cancer treatments like hormone or radiation therapy than patients who have traditional open radical prostatectomy (ORP) or “open” surgery.
The study, published online February 19, 2014 issue of the journal European Urology, was led by Jim Hu, MD, UCLA’s Henry E. Singleton Professor of Urology and director of robotic and minimally invasive surgery in the urology department at the David Geffen School of Medicine at UCLA.
…This procedure may translate into less downstream costs and fewer side effects from radiation and hormone therapy…
Controversial
Although it is becoming more popular, robotic-assisted radical prostatectomy ? the complete removal of the prostate using a robotic apparatus ? remains controversial because there has been little evidence that it provides better cancer control than open radical prostatectomy, the traditional surgical approach, which is less costly.
In an effort to determine whether or not robotic surgery offered an advantage, Hu and his colleagues compared 5,556 patients who received robotic surgery with 7,878 who underwent open surgery between 2004 and 2009. Data was provided by the Surveillance, Epidemiology, and End Results?Medicare (SEER), a program of cancer registries that collect clinical and demographic information on people with cancer.
The researchers looked at the surgical margin status of the two groups, which is the amount of cancer cells at the edge of the removed prostate specimen. A positive margin ? the presence of cancer cells at the edge ? may result from cutting through the cancer and leaving some behind rather than cutting around the cancer completely. In prostate cancer, this has been shown to lead to a greater risk of recurrence and death from the disease.
The team also assessed the use of additional cancer therapies ? a hormone therapy known as androgen deprivation, as well as radiation ? after robotic surgery and open surgery.
Fewer positive margins
The researchers found that robotic prostate surgery was associated with 5 percent fewer positive margins (13.6% vs. 18.3%); this difference was greater for patients with intermediate and high-risk prostate cancer. Patients who had robotic surgery also had a one-third reduction in the likelihood of needing additional cancer therapies within 24 months after surgery.
Despite the greater up-front cost of robotic surgery, the findings show that the procedure may translate into less downstream costs and fewer side effects from radiation and hormone therapy, the researchers said.
For more information:
Hu JC, Gandaglia G, Karakiewicz PI, Nguyen PL, Trinh QD, Tina Shih YC, Abdollah F et al. Comparative Effectiveness of Robot-assisted Versus Open Radical Prostatectomy Cancer Control Journal European Eurology 2 (19) 2014 DOI: 10.1016/j.eururo.2014.02.015 online [Article]
Photo:Dr. Jim Hu, UCLA’s Henry E. Singleton Professor of Urology; director of robotic and minimally invasive surgery in the urology department at the David Geffen School of Medicine at UCLA; and a member of UCLA’s Jonsson Comprehensive Cancer Center.Photo courtesy:UCLA.
Copyright ? 2014 InPress Media Group/Sunvalley Communication. All rights reserved. Republication or redistribution of InPress Media Group/Sunvalley Communication content, including by framing or similar means, is expressly prohibited without the prior written consent of InPress Media Group/Sunvalley Communication.InPress Media Group/Sunvalley Communication shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Onco’Zine and Oncozine are registered trademarks and trademarks of Sunvalley Communication around the world.
