title: Surgical method influences specimen margins and biochemical recurrence during radical prostatectomy for high-risk prostate cancer: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To perform a meta-analysis comparing the rates of positive surgical margins (PSM) and biochemical recurrence (BCR) between open radical prostatectomy (ORP) and robot-assisted radical prostatectomy (RARP) in patients with high-risk prostate cancer.
  
  
  METHODS
  A systematic review was performed on Pubmed, Embase and Scopus databases in August 2016, according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. References retrieved were evaluated using the Newcastle-Ottawa scale and the Black and Down's tool for quality assessment.
  
  
  RESULTS
  Nine retrospective cohorts comparing ORP and RARP were selected and included in the meta-analysis. All studies reported the PSMs. Patients treated with RARP presented less risk of PSMs (risk difference -0.04, p 0.02) than those treated with ORP. Five articles reported hazard ratios for BCR-free survival. Patients treated with RARP had less risk of BCR (HR 0.72, 95% CI 0.58-0.89) than those treated with ORP. Reports for PSM assessment were considered of adequate quality, while the studies retrieved for BCR assessment were considered limited because of the heterogeneity of their results.
  
  
  CONCLUSIONS
  Patients with high-risk prostate cancer treated with RARP have less risk of having PSM and BCR when compared to those treated with ORP. A strong conclusion is precluded due to the observational nature of the studies retrieved for our analysis.
authors.affiliation: Department of Urology, Institute Mutualist Montsouris, Université Paris-Descartes, 42, Boulevard Joudan, 75674, Paris, France.|Division of Urology, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Victor
authors.initials: V
authors.lastname: Srougi
authors.affiliation: Division of Urology, Federal University of Feira de Santana, Bahia, Brazil.
authors.forename: Jose
authors.initials: J
authors.lastname: Bessa
authors.affiliation: Department of Urology, Institute Mutualist Montsouris, Université Paris-Descartes, 42, Boulevard Joudan, 75674, Paris, France.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Baghdadi
authors.affiliation: Department of Urology, Institute Mutualist Montsouris, Université Paris-Descartes, 42, Boulevard Joudan, 75674, Paris, France.
authors.forename: Igor
authors.initials: I
authors.lastname: Nunes-Silva
authors.affiliation: Department of Urology, Institute Mutualist Montsouris, Université Paris-Descartes, 42, Boulevard Joudan, 75674, Paris, France.
authors.forename: Jose Batista
authors.initials: JB
authors.lastname: da Costa
authors.affiliation: Department of Urology, Institute Mutualist Montsouris, Université Paris-Descartes, 42, Boulevard Joudan, 75674, Paris, France.
authors.forename: Silvia
authors.initials: S
authors.lastname: Garcia-Barreras
authors.affiliation: Department of Urology, Institute Mutualist Montsouris, Université Paris-Descartes, 42, Boulevard Joudan, 75674, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Barret
authors.affiliation: Department of Urology, Institute Mutualist Montsouris, Université Paris-Descartes, 42, Boulevard Joudan, 75674, Paris, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Rozet
authors.affiliation: Department of Urology, Institute Mutualist Montsouris, Université Paris-Descartes, 42, Boulevard Joudan, 75674, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Galiano
authors.affiliation: Department of Urology, Institute Mutualist Montsouris, Université Paris-Descartes, 42, Boulevard Joudan, 75674, Paris, France. rafael.sanchez-salas@imm.fr.
authors.forename: Rafael
authors.initials: R
authors.lastname: Sanchez-Salas
authors.affiliation: Department of Urology, Institute Mutualist Montsouris, Université Paris-Descartes, 42, Boulevard Joudan, 75674, Paris, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Cathelineau
mesh_terms: D000954:Antigens, Surface / Q000032:analysis*; D043425:Glutamate Carboxypeptidase II / Q000032:analysis*; D006801:Humans; D008297:Male; D000072662:Margins of Excision; D011379:Prognosis; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery; D018570:Risk Assessment; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods
chemical_list: D000954:Antigens, Surface; C473848:FOLH1 protein, human; D043425:Glutamate Carboxypeptidase II
keywords: High risk; Open radical prostatectomy; Prostate cancer; Robot-assisted radical prostatectomy