You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History1 Apr 2011151 QUALITY OF LIFE CHANGES FOLLOWING RADICAL PROSTATECTOMY: A PROSPECTIVE COMPARISON OF ROBOTIC & OPEN TECHNIQUES James Symons, Ruban THANIGASALAM, Richard Savdie, David Smith, Sam Egger, Ruth Pe Benito, Anne Maree Haynes, Amanda Siriwardana, Jayne Matthews, Phillip Brenner, Robert Sutherland, Krishnan Rasiah, and Phillip Stricker James SymonsJames Symons Darlinghurst, Australia More articles by this author , Ruban THANIGASALAMRuban THANIGASALAM Darlinghurst, Australia More articles by this author , Richard SavdieRichard Savdie Darlinghurst, Australia More articles by this author , David SmithDavid Smith King's Cross, Australia More articles by this author , Sam EggerSam Egger King's Cross, Australia More articles by this author , Ruth Pe BenitoRuth Pe Benito Darlinghurst, Australia More articles by this author , Anne Maree HaynesAnne Maree Haynes Darlinghurst, Australia More articles by this author , Amanda SiriwardanaAmanda Siriwardana Darlinghurst, Australia More articles by this author , Jayne MatthewsJayne Matthews Darlinghurst, Australia More articles by this author , Phillip BrennerPhillip Brenner Darlinghurst, Australia More articles by this author , Robert SutherlandRobert Sutherland Darlinghurst, Australia More articles by this author , Krishnan RasiahKrishnan Rasiah St. Leonards, Australia More articles by this author , and Phillip StrickerPhillip Stricker Darlinghurst, Australia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.219AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES It is increasingly evident in men with prostate cancer (PC) that treatment satisfaction is not solely due to oncological outcome. From May 2007, men in a high-volume tertiary referral centre with newly diagnosed localised PC have been recruited to assess how contemporary treatments currently affect their health related quality of life (HRQoL). Here, we compare robotic RP (RALP) to open radical prostatectomy (RP) as done by experienced surgeons (>2,000 open cases by primary surgeon). METHODS The study cohort comprises men treated to April 2010. Those previously treated for PC or with metastases at diagnoses were excluded. General & disease specific QOL outcomes were recorded using the expanded prostate cancer index composite (EPIC) & SF-12 health survey. Demographic & clinical variables were linked to a pathological database. Patients were grouped by operative technique & surgeon's experience with RALP (<200, ≥200 cases). Subgroup analysis was based upon pre-operative continence & potency (IIEF-5 score ≥20). Multivariate regression analyses with generalised estimating equations were used to estimate adjusted mean differences in scores. RESULTS Of 466 eligible patients, 188 underwent RP & 278 RALP. Of the latter, 163 were by surgeon with experience <200 cases & 115 with experience ≥200. Patient reported outcomes were collected longitudinally to 24 months (response rate = 88–100%). Patient satisfaction was high (mean score > 80) amongst all groups. RALP ≥200 was associated with higher urinary scores by 12 months. Specifically, irritative/obstructive & bother scores improved from baseline in RALP ≥200 (+5.7, p<0.001 & +6.0, p<0.001, respectively), whilst urinary continence was not significantly different from baseline (p=0.187). Absolute continence was more likely during follow-up for RALP ≥200 than RP (OR=1.67, p=0.035). All groups had significant decline from baseline sexual domain scores persisting beyond 12 months. RALP ≥200 had less initial decline than RP in sexual function, bother & summary scores, though differences were non-significant by 12 months (p=0.697, p=0.459, p=0.962, respectively). Across all groups, < 70% of men were potent pre-operatively; compared to RP, RALP ≥200 was more likely to be potent post-operatively (OR= 1.54, p=0.22), with RALP<200 less likely (OR=0.46, p=0.032). CONCLUSIONS RALP may offer functional results that can surpass those of an experienced open surgeon. With experience, it was associated with significantly improved post-operative outcomes in a number of urinary & sexual domains. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e63-e64 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information James Symons Darlinghurst, Australia More articles by this author Ruban THANIGASALAM Darlinghurst, Australia More articles by this author Richard Savdie Darlinghurst, Australia More articles by this author David Smith King's Cross, Australia More articles by this author Sam Egger King's Cross, Australia More articles by this author Ruth Pe Benito Darlinghurst, Australia More articles by this author Anne Maree Haynes Darlinghurst, Australia More articles by this author Amanda Siriwardana Darlinghurst, Australia More articles by this author Jayne Matthews Darlinghurst, Australia More articles by this author Phillip Brenner Darlinghurst, Australia More articles by this author Robert Sutherland Darlinghurst, Australia More articles by this author Krishnan Rasiah St. Leonards, Australia More articles by this author Phillip Stricker Darlinghurst, Australia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...