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Cleveland Clinic Study Shows Similar Quality-of-Life Outcomes After Robotic&Open Surgery to Treat Prostate Cancer

Head-to-Head Treatment Study Reports Prospective Patient Data

December 3, 2012

Cleveland Clinic researchers presented the results of a study at the Winter Meeting of the Society of Urologic Oncology. The study of more than 300 prostate cancer patients over a two-year period shows that urinary continence and sexual function scores are similar after robotic-assisted laparoscopic radical prostatectomy (RALRP) and open radical prostatectomy (ORP). Whether patients underwent RALRP or ORP at a high-volume hospital, they reported similar quality-of-life outcomes.

Researchers compared urinary continence and sexual function among 190 patients treated by RALRP and 171 patients treated by ORP at Cleveland Clinic. The 361 patients were enrolled in a prospective, longitudinal quality-of-life protocol. Researchers concluded that the technical skill of the surgeon appears to be a major determinant of a successful outcome. 

“These operations were performed by high-volume experienced surgeons in their field, which may explain the absence of significant differences in the outcomes,” said Andrew Stephenson, MD, a urologist in the Glickman Urological and Kidney Institute at Cleveland Clinic. “This suggests that the experience and technique of the individual surgeon play the greatest role in achieving a successful outcome rather than the surgical approach that is employed.”

RALRP is a minimally invasive technique that allows surgeons to operate through small ports. It has been gaining popularity over the open prostate surgery, where the prostate gland is removed through a larger incision in the lower abdomen.

Dr. Stephenson used a validated quality-of-life instrument (Giesler RB et al. Qual Life Res 2000) to determine the impact of RALRP and ORP on urinary continence and sexual function. Functional outcomes were assessed at baseline and at 1, 3, 6, 12, and 24 months. Prospectively collected, patient reported similar sexual function after RALRP and ORP at all time points. Urinary continence is similar between both techniques, although RALRP patients may experience a slightly slower return to continence. 

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