Robot-assisted laparoscopic prostatectomy and open radical retropubic prostatectomy are associated with similar functional outcomes at 12 weeks, suggesting that patients with prostate cancer requiring surgery should choose a trusted, experienced surgeon rather than a particular surgical approach, according to a study published in The Lancet.1

Data comparing robot-assisted laparoscopic prostatectomy and open radical retropubic prostatectomy are sparse; researchers evaluated the functional and oncologic outcomes of these 2 approaches in a phase 3 study.

Investigators enrolled 326 men aged 35 to 70 years with newly diagnosed clinically localized prostate cancer who opted for surgery, and for whom the estimated life expectancy was 10 years or more. Participants were randomly assigned 1:1 to receive robot-assisted laparoscopic prostatectomy or radical retropubic prostatectomy.

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One hundred and twenty-one patients assigned to radical retropubic prostatectomy and 131 assigned to laparoscopic prostatectomy completed a questionnaire assessing urinary and sexual function at 12 weeks.

Urinary function scores did not differ between the 2 groups at either 6 weeks post-surgery (P = .09) or 12 weeks post-surgery (P = .48). It was also found that there was no significant difference in sexual function scores between the 2 arms at 6 weeks after surgery (P = .45) or 12 weeks after surgery (P = .18).

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Neither surgical approach was superior to the other with respect to the proportion of positive surgical margins after surgery (P = .21). The authors note that longer term follow-up is necessary.                           


  1. Yaxley JW, Coughlin GD, Chambers SK, et al. Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study. Lancet. 2016 Jul 26. doi: 10.1016/S0140-6736(16)30592-X [Epub ahead of print]