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01-03-2015 | Original Article

Matched comparison of robot‐assisted, laparoscopic and open radical prostatectomy regarding pathologic and oncologic outcomes in obese patients

Authors: Jonas Busch, Mark L. Gonzalgo, Natalia Leva, Michelle Ferrari, Hannes Cash, Carsten Kempkensteffen, Stefan Hinz, Kurt Miller, Ahmed Magheli

Published in: World Journal of Urology | Issue 3/2015

Abstract

Objectives

To investigate pathological and oncological outcomes of obese patients who underwent robot-assisted radical prostatectomy (RARP) compared with laparoscopic radical prostatectomy (LRP) or open retropubic radical prostatectomy (RRP) since limited comparative data exist with regard to oncological and survival outcomes.

Methods

A total of 869 patients with body mass index ≥30 from two academic centers were identified. A total of 194 patients who underwent RARP were propensity score (PS) matched 1:1 to LRP or RRP cases. PS-matching variables included prostate-specific antigen (PSA), biopsy Gleason score, clinical stage, surgeon experience, and nerve-sparing technique. Predictors of positive surgical margins (PSMs) were analyzed using logistic regression. Predictors of recurrence-free survival (RFS) were analyzed within Cox regression models. Overall survival was compared with RFS using the log-rank test.

Results

Pathologic Gleason scores <7, =7, and >7 were found in 24.2, 63.6, and 11.7 % of patients, respectively. There were no statistically significant differences related to pathologic stage or lymph node metastases between surgical techniques. PSM for pT2 disease were observed in 22.9, 17.4, and 19.3 % of patients undergoing RARP, LRP, and RRP, respectively (not significantly different). Preoperative PSA and clinical stage cT2 disease were independently associated with PSM. There were no significant differences in mean 3-year RFS for RARP, LRP, and RRP (87.4, 91.0, and 85.7 %). Biopsy Gleason score >7, PSM, and clinical stage two were independent predictors of decreased RFS.

Conclusions

RARP demonstrates similar pathological and oncological results compared with LRP or RRP for obese patients.

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Title: Matched comparison of robot‐assisted, laparoscopic and open radical prostatectomy regarding pathologic and oncologic outcomes in obese patients
Authors: Jonas Busch
Mark L. Gonzalgo
Natalia Leva
Michelle Ferrari
Hannes Cash
Carsten Kempkensteffen
Stefan Hinz
Kurt Miller
Ahmed Magheli
Publication date: 01-03-2015
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 3/2015
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-014-1326-1

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Springer Medicine

Matched comparison of robot‐assisted, laparoscopic and open radical prostatectomy regarding pathologic and oncologic outcomes in obese patients

Abstract

Objectives

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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