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Title: Perioperative, functional and oncological outcomes after open and minimally invasive prostate cancer surgery: experience from Australasia.
Authors: Murphy, Declan
Moon, Daniel
Costello, Anthony
Frydenberg, Mark
Other Authors: Cathcart, Paul
Keywords: Length of Stay
Minimally Invasive Surgical Procedures
Adverse Effects
Neoplasm Invasiveness
Postoperative Pain
Perioperative Period
Postoperative Complications
Prostatic Neoplasms
Quality of Life
Risk Assessment
Survival Rate
Treatment Outcome
Prostate Cancer
Australian Prostate Cancer Research Centre at Epworth Hospital, Richmond, Victoria, Australia
Cancer Services Clinical Institute, Epworth HealthCare, Victoria, Australia
UroRenal, Vascular Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Apr-2011
Publisher: Wiley
Citation: BJU Int. 2011 Apr;107 Suppl 3:11-9.
Abstract: OBJECTIVE: •  To systematically review the current literature concerning perioperative, functional and oncological outcomes reported after open and minimally invasive prostate cancer surgery specifically from institutions within Australasia. MATERIALS AND METHODS: •  Four electronic databases were searched to identify studies reporting outcome after open and minimally invasive prostate cancer surgery. Studies were sought using the search term 'radical prostatectomy'. •  In all, 11,378 articles were retrieved. For the purpose of this review, data were only extracted from studies reporting Australasian experience. •  A total of 28 studies met final inclusion criteria. RESULTS: •  Overall, the data are limited by the low methodological quality of available studies. •  Only two comparative studies evaluating open radical prostatectomy (ORP) and robotic-assisted laparoscopic RP (RALP) were identified, both non-randomized. •  The mean blood loss, catheterization time and hospital stay was shorter after RALP than with ORP. In contrast, mean operative procedure time was significantly longer for RALP. •  Overall adverse event rates were similar for the different surgical approaches although the rate of bladder neck stricture was significantly higher after open RP. •  Incorporation of patient outcomes achieved by surgeons still within their learning curve resulted in a trend towards higher positive surgical margin rates and lower continence scores after RALP. However, there was equivalence once the surgeons' learning curve was overcome. Given the limited follow-up for RALP and laparoscopic RP (14.7 and 6 months vs 43.8 months for ORP) and the lack of data concerning erectile function status, comparison of biochemical failure and potency was not possible. CONCLUSIONS: •  Few comparative data are available from Australasia concerning open and minimally invasive prostate cancer surgery. •  While perioperative outcomes appear to favour minimally invasive approaches, further comparative assessment of functional and long-term oncological efficacy for the different surgical approaches is required to better define the role of minimally invasive approaches.
DOI: 10.1111/j.1464-410X.2011.10053.x
PubMed URL:
ISSN: 1464-410X
Journal Title: BJU International
Type: Journal Article
Affiliated Organisations: Department of Urology, Royal Melbourne Hospital, Melbourne, Australia.
Division of Surgical Oncology, Peter MacCallum Cancer Centre.
Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne.
Department of Urology, Monash Medical Centre.
Department of Surgery, Monash University, Melbourne, Australia.
Type of Clinical Study or Trial: Systematic Reviews
Appears in Collections:Cancer Services
Epworth Prostate Centre
UroRenal, Vascular

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