When performed by experienced prostate cancer surgeons at a center of excellence, laparoscopic radical prostatectomy (LRP) and open retropubic radical prostatectomy (RRP) have comparable outcomes in the treatment of clinically localized prostate cancer.
The single-center investigation by urologists from Memorial Sloan-Kettering Cancer Center, New York, reviewed pro-spectively collected data from 1,431 consecutive men who were operated on between Jan. 1, 2003, and Dec. 31, 2005. Surgical approach was selected by the patient; 613 men had the minimally invasive procedure and 818 men underwent open surgery. Two surgeons performed all of the open procedures; two others, all of the laparoscopic cases.
Dr. Touijer observed that other investigators have compared their experiences with LRP and RRP. However, the RRP patients in those reports are usually historical controls operated on during a prior period of time, and the analyses are usually based on data extracted retrospectively.
"Those methods may result in bias against the laparoscopic series from including patients operated on during the procedure's learning curve, and carry the inherent limitations associated with a retrospective study," Dr. Touijer told Urology Times.
"The open technique has been mature for many years, and the positive margin rate in our RRP group was fairly stable across the 3-year period. In contrast, the positive margin rates in the LRP group decreased steadily and significantly over time, whether the data were analyzed overall or with patients stratified by pathological disease stage (pT2 or pT3)," Dr. Touijer said.