Robot assisted radical prostatectomy: the new standard?

A. A. Laviana, Stephen Williams, E. D. King, R. J. Chuang, J. C. Hu

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

Over the past decade, the robotic assisted radical prostatectomy (RARP) has grown increasingly popular and quickly equated itself as the most commonly used modality to treat locally-confined prostate cancer. Despite increased utilization, there is limited comparative research demonstrating superiority for RARP over the conventional radical retropubic prostatectomy (RRP). Furthermore, though perioperative and short-term oncologic outcomes are equivalent if not superior for the robotic approach, the optimal utilization of robotic technology remains to be determined with cost serving as a primary driver. In this review, we performed a literature search to identify comparative effectiveness research as it pertains to RARP versus RRP. We performed a PubMed literature search for a review of articles published between 2000 and 2014 using the following keywords to identify pertinent research: "robot or robotic prostatectomy", "open or retropubic prostatectomy", "cost", "resource utilization". Long-term data comparing RARP and RRP remains limited, though short-term positive surgical margins, biochemical recurrence-free survival, and need for adjuvant therapy appear at least equivocal, if not in favor of RARP versus RRP. Functional outcomes including return of continence and potency favor RARP while cost still favors RRP. Nonetheless, the generalization of results remains difficult with surgeon volume playing a large role in improving efficiency and quality. For the foreseeable future, an increasing number of prostatectomies will continue to be performed robotically. Though RARP appears to offer improved functional outcomes with good short-term oncologic outcomes, there is a need for longer-term studies to assess the true value of RARP. Outcomes aside, rigorous, prospective randomized-controlled trials must also be performed on the cost-effectiveness of RARP to determine its overall utility in an era of health care delivery reform.

Original languageEnglish (US)
Pages (from-to)47-53
Number of pages7
JournalMinerva Urologica e Nefrologica
Volume67
Issue number1
StatePublished - Mar 1 2015
Externally publishedYes

Fingerprint

Prostatectomy
Robotics
Costs and Cost Analysis
Comparative Effectiveness Research
Health Care Reform
Research
PubMed
Cost-Benefit Analysis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Laviana, A. A., Williams, S., King, E. D., Chuang, R. J., & Hu, J. C. (2015). Robot assisted radical prostatectomy: the new standard? Minerva Urologica e Nefrologica, 67(1), 47-53.

Robot assisted radical prostatectomy : the new standard? / Laviana, A. A.; Williams, Stephen; King, E. D.; Chuang, R. J.; Hu, J. C.

In: Minerva Urologica e Nefrologica, Vol. 67, No. 1, 01.03.2015, p. 47-53.

Research output: Contribution to journalReview article

Laviana, AA, Williams, S, King, ED, Chuang, RJ & Hu, JC 2015, 'Robot assisted radical prostatectomy: the new standard?', Minerva Urologica e Nefrologica, vol. 67, no. 1, pp. 47-53.
Laviana, A. A. ; Williams, Stephen ; King, E. D. ; Chuang, R. J. ; Hu, J. C. / Robot assisted radical prostatectomy : the new standard?. In: Minerva Urologica e Nefrologica. 2015 ; Vol. 67, No. 1. pp. 47-53.
@article{fbe9f389c9d648278573c014495b21da,
title = "Robot assisted radical prostatectomy: the new standard?",
abstract = "Over the past decade, the robotic assisted radical prostatectomy (RARP) has grown increasingly popular and quickly equated itself as the most commonly used modality to treat locally-confined prostate cancer. Despite increased utilization, there is limited comparative research demonstrating superiority for RARP over the conventional radical retropubic prostatectomy (RRP). Furthermore, though perioperative and short-term oncologic outcomes are equivalent if not superior for the robotic approach, the optimal utilization of robotic technology remains to be determined with cost serving as a primary driver. In this review, we performed a literature search to identify comparative effectiveness research as it pertains to RARP versus RRP. We performed a PubMed literature search for a review of articles published between 2000 and 2014 using the following keywords to identify pertinent research: {"}robot or robotic prostatectomy{"}, {"}open or retropubic prostatectomy{"}, {"}cost{"}, {"}resource utilization{"}. Long-term data comparing RARP and RRP remains limited, though short-term positive surgical margins, biochemical recurrence-free survival, and need for adjuvant therapy appear at least equivocal, if not in favor of RARP versus RRP. Functional outcomes including return of continence and potency favor RARP while cost still favors RRP. Nonetheless, the generalization of results remains difficult with surgeon volume playing a large role in improving efficiency and quality. For the foreseeable future, an increasing number of prostatectomies will continue to be performed robotically. Though RARP appears to offer improved functional outcomes with good short-term oncologic outcomes, there is a need for longer-term studies to assess the true value of RARP. Outcomes aside, rigorous, prospective randomized-controlled trials must also be performed on the cost-effectiveness of RARP to determine its overall utility in an era of health care delivery reform.",
author = "Laviana, {A. A.} and Stephen Williams and King, {E. D.} and Chuang, {R. J.} and Hu, {J. C.}",
year = "2015",
month = "3",
day = "1",
language = "English (US)",
volume = "67",
pages = "47--53",
journal = "Minerva Urologica e Nefrologica",
issn = "0393-2249",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "1",

}

TY - JOUR

T1 - Robot assisted radical prostatectomy

T2 - the new standard?

AU - Laviana, A. A.

AU - Williams, Stephen

AU - King, E. D.

AU - Chuang, R. J.

AU - Hu, J. C.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Over the past decade, the robotic assisted radical prostatectomy (RARP) has grown increasingly popular and quickly equated itself as the most commonly used modality to treat locally-confined prostate cancer. Despite increased utilization, there is limited comparative research demonstrating superiority for RARP over the conventional radical retropubic prostatectomy (RRP). Furthermore, though perioperative and short-term oncologic outcomes are equivalent if not superior for the robotic approach, the optimal utilization of robotic technology remains to be determined with cost serving as a primary driver. In this review, we performed a literature search to identify comparative effectiveness research as it pertains to RARP versus RRP. We performed a PubMed literature search for a review of articles published between 2000 and 2014 using the following keywords to identify pertinent research: "robot or robotic prostatectomy", "open or retropubic prostatectomy", "cost", "resource utilization". Long-term data comparing RARP and RRP remains limited, though short-term positive surgical margins, biochemical recurrence-free survival, and need for adjuvant therapy appear at least equivocal, if not in favor of RARP versus RRP. Functional outcomes including return of continence and potency favor RARP while cost still favors RRP. Nonetheless, the generalization of results remains difficult with surgeon volume playing a large role in improving efficiency and quality. For the foreseeable future, an increasing number of prostatectomies will continue to be performed robotically. Though RARP appears to offer improved functional outcomes with good short-term oncologic outcomes, there is a need for longer-term studies to assess the true value of RARP. Outcomes aside, rigorous, prospective randomized-controlled trials must also be performed on the cost-effectiveness of RARP to determine its overall utility in an era of health care delivery reform.

AB - Over the past decade, the robotic assisted radical prostatectomy (RARP) has grown increasingly popular and quickly equated itself as the most commonly used modality to treat locally-confined prostate cancer. Despite increased utilization, there is limited comparative research demonstrating superiority for RARP over the conventional radical retropubic prostatectomy (RRP). Furthermore, though perioperative and short-term oncologic outcomes are equivalent if not superior for the robotic approach, the optimal utilization of robotic technology remains to be determined with cost serving as a primary driver. In this review, we performed a literature search to identify comparative effectiveness research as it pertains to RARP versus RRP. We performed a PubMed literature search for a review of articles published between 2000 and 2014 using the following keywords to identify pertinent research: "robot or robotic prostatectomy", "open or retropubic prostatectomy", "cost", "resource utilization". Long-term data comparing RARP and RRP remains limited, though short-term positive surgical margins, biochemical recurrence-free survival, and need for adjuvant therapy appear at least equivocal, if not in favor of RARP versus RRP. Functional outcomes including return of continence and potency favor RARP while cost still favors RRP. Nonetheless, the generalization of results remains difficult with surgeon volume playing a large role in improving efficiency and quality. For the foreseeable future, an increasing number of prostatectomies will continue to be performed robotically. Though RARP appears to offer improved functional outcomes with good short-term oncologic outcomes, there is a need for longer-term studies to assess the true value of RARP. Outcomes aside, rigorous, prospective randomized-controlled trials must also be performed on the cost-effectiveness of RARP to determine its overall utility in an era of health care delivery reform.

UR - http://www.scopus.com/inward/record.url?scp=84953342939&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84953342939&partnerID=8YFLogxK

M3 - Review article

C2 - 25424387

AN - SCOPUS:84953342939

VL - 67

SP - 47

EP - 53

JO - Minerva Urologica e Nefrologica

JF - Minerva Urologica e Nefrologica

SN - 0393-2249

IS - 1

ER -