Prospective Multicenter Comparison of Open and Robotic Radical Prostatectomy: The PROST-QA/RP2 Consortium

Area of Science:

• Urology
• Surgical Oncology
• Health Services Research

Background:

• Robot-assisted laparoscopic prostatectomy (RALP) and open radical prostatectomy (ORP) are common surgical treatments for localized prostate cancer.
• Comparative effectiveness studies are crucial for guiding clinical decision-making.

Purpose of the Study:

• To compare the effectiveness of RALP versus ORP in a multicenter study.
• To evaluate differences in patient-reported health-related quality of life (HRQOL) and perioperative outcomes.

Main Methods:

• A multicenter study involving 11 academic medical centers in the US.
• Comparison of 549 RALP patients and 545 ORP patients from the PROST-QA and PROST-QA/RP2 cohorts.
• Longitudinal assessment of HRQOL, pathological outcomes, and perioperative complications.

Main Results:

• RALP was associated with significantly less intraoperative blood loss, shorter hospital stays, and fewer blood transfusions compared to ORP.
• RALP patients experienced fewer infections, deep venous thromboses, and bladder neck contractures.
• RALP was linked to less pain and higher incision satisfaction, though both approaches yielded similar longitudinal HRQOL outcomes.

Conclusions:

• RALP and ORP provide comparable long-term HRQOL outcomes for prostate cancer patients in high-volume academic centers.
• RALP offers advantages including reduced pain, shorter hospitalization, and a lower incidence of specific post-surgical complications.