title: Experienced Open vs Early Robotic-assisted Laparoscopic Radical Prostatectomy: A 10-year Prospective and Retrospective Comparison.
abstract: To undertake a prospective/retrospective comparison of longer-term oncologic and quality of life outcomes in open radical prostatectomy (ORP) or robotic-assisted laparoscopic radical prostatectomy (RALP) patients.
  
  
  
  The clinical progression of ORP and RALP patients who underwent surgery during 2004 was followed over an extended (10 year) period. Pre- and perioperative parameters, oncologic outcomes, recurrence, mortality, and quality of life were compared between surgical modalities. Follow-up time was calculated from the time of surgery to the latest contact. Postoperative quality of life data were obtained from Expanded Prostate Cancer Index Composite survey questionnaires. Recurrence rates, times to recurrence, surgical time, length of stay, hematocrit, follow-up time, and sexual and urinary bother scores were compared between surgical groups. Multivariate analyses were used to predict positive surgical margins and biochemical recurrence.
  
  
  
  63 ORP and 116 RALP patients were included (mean age of 60.4 ± 6.4 and 58.6 ± 5.8 years; P = .067), with follow-up times of 10.3 and 10.1 years (P = .191). RALP patients had longer operative times (P < .001), shorter hospital stays (P < .001), and higher discharge hematocrits (P < .001). With prostate-specific antigen, Gleason score, and T-stage as covariates, time to recurrence (P = .365) and positive margin rate (P = .230) were not statistically different between groups. Ninety-five percent of RALP patients were continent and 48.0% were potent vs 92.6% and 41.5% of ORP patients (P = .720; .497). Urinary and sexual bother were not significantly different between groups (P = .392; .985).
  
  
  
  Our longer-term follow-up data suggest that ORP and RALP patients have comparable oncologic and quality of life outcomes.
authors.affiliation: Urology Division, Hartford Hospital, Hartford, CT.
authors.forename: Max A
authors.initials: MA
authors.lastname: Jackson
authors.affiliation: Urology Division, Hartford Hospital, Hartford, CT.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Bellas
authors.affiliation: Urology Service, Middlesex Hospital, Middletown, CT.
authors.forename: Timothy
authors.initials: T
authors.lastname: Siegrist
authors.affiliation: Urology Division, Hartford Hospital, Hartford, CT. Electronic address: peter.haddock@hhchealth.org.
authors.forename: Peter
authors.initials: P
authors.lastname: Haddock
authors.affiliation: Research Program, Hartford Hospital, Hartford, CT.
authors.forename: Ilene
authors.initials: I
authors.lastname: Staff
authors.affiliation: Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Vincent
authors.initials: V
authors.lastname: Laudone
authors.affiliation: Urology Division, Hartford Hospital, Hartford, CT.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Wagner
mesh_terms: D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011788:Quality of Life; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D013997:Time Factors