[A prospective trial comparing consecutive series of open retropubic and robot-assisted laparoscopic radical prostatectomy in a centre: Oncologic and functional outcomes].
OBJECTIVE
Radical prostatectomy (RP) is an oncologic and functional challenge. Few series compare prospectively the two approaches, open retropubic (ORP) and laparoscopic robot-assisted RP (LRARP). The objective was to compare the oncological and functional results of ORP and LRARP.


METHODS
From January 2009 to March 2012, two practiced surgeons conducted 304 consecutive RP: respectively 129 ORP and 175 LRARP. Preoperative, perioperative and postoperative data (location and size of positive surgical margins [PSM]) were recorded prospectively and compared with oncological results (PSM, biochemical recurrence-free survival [BCR]) and functional outcomes (urinary and erectile) by self-validated questionnaires (USP, IIEF-15). The comparison was made by the Chi(2) test and Student t-test for qualitative and quantitative variables.


RESULTS
The preoperative data 2 groups were comparable. MCP rate was 13.2% for the ORP and 20% for the LRARP (ns) and was 1.4% and 29.6% (ORP) versus 9.4% and 36.7% (LRARP) for pT2 and pT3 for respectively (P=0.078). BCR was the same in both groups (95.2% at 13.1 months). At 12 months, the results of continence showed no difference (P=0.49) and about erectile function, the EF-score was significantly higher in LRARP: 22 versus 17 for the ORP (P=0.03).


CONCLUSIONS
Oncological results were comparable after ORP and LRARP. The recovery of continence was excellent regardless of the surgical technique, the recovery of erectile function a bit faster by LRARP.


METHODS
3.
Département d'urologie, andrologie et transplantation rénale, CHU Rangueil, 1, avenue Jean-Pouilhès, 31059 Toulouse cedex, France. Electronic address: jbbeauval@gmail.com.
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JB
Beauval
Département d'urologie, andrologie et transplantation rénale, CHU Rangueil, 1, avenue Jean-Pouilhès, 31059 Toulouse cedex, France.
M
M
Roumiguié
Département d'études statistiques, IUC Oncopôle, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
M
M
Ouali
Département d'urologie, andrologie et transplantation rénale, CHU Rangueil, 1, avenue Jean-Pouilhès, 31059 Toulouse cedex, France.
N
N
Doumerc
Département d'urologie, andrologie et transplantation rénale, CHU Rangueil, 1, avenue Jean-Pouilhès, 31059 Toulouse cedex, France.
M
M
Thoulouzan
Département d'anatomopathologie, IUC Oncopôle, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
C
C
Mazerolles
Département d'urologie, andrologie et transplantation rénale, CHU Rangueil, 1, avenue Jean-Pouilhès, 31059 Toulouse cedex, France.
P
P
Rischmann
Département d'urologie, andrologie et transplantation rénale, CHU Rangueil, 1, avenue Jean-Pouilhès, 31059 Toulouse cedex, France.
B
B
Malavaud
Département d'urologie, andrologie et transplantation rénale, CHU Rangueil, 1, avenue Jean-Pouilhès, 31059 Toulouse cedex, France.
M
M
Soulié
D000328:Adult; D000368:Aged; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D065287:Robotic Surgical Procedures; D016896:Treatment Outcome; D014554:Urination
Cancer de la prostate; Carcinologique; Fonctionnel; Laparoscopic robot-assisted RP; Oncologic and functional outcomes; Open RP; Prostate cancer; Prostatectomie totale laparoscopique robot-assistée; Prostatectomie totale rétropubienne; Radical prostatectomy (RP)