Introduction

The aim of this study was to report the 5-year functional and oncologic outcomes of our previously published prospective randomized study comparing RARP vs LRP.

Methods

From 1/2010 to 1/2011, 120 patients with organ-confined prostate cancer were enrolled and randomly assigned to RARP or LRP. All patients were treated by a single surgeon with a trans-peritoneal anterograde approach. Continence, potency and serum PSA were reported at 1,3,6,12 months and then every 6 months until the 60th month postoperatively. Complications _x000D_ For the survival analysis biochemical Recurrence (BCR) was defined as any postoperative cancer treatment (radiation, hormonal/chemotherapy) or PSA above 0.2 ng/ml._x000D_ A Generalized Estimating Equations model was used to compare the time series of functional results, Kaplan-Meier and Cox model were used to analyse the oncologic outcomes.

Results

The probability to be continent and potent over time was more than doubled in the RARP group (OR 2.47, p<0.021 and OR 2.35, p<0.028, respectively)._x000D_ Five years BCRFS was 81.6% for both the RARP and LRP groups. At Cox proportional hazards models Pathological GS, Positive surgical margins (PSMs) and pT (pT3a vs pT2; pT3b vs pT2) stage were associated with a significant increase of BCR risk (HR 3.74, 4.61, 2.80 and 12.69, respectively) _x000D_ None of the patients died due to oncological causes; conversely, three patients in the RARP group and two patients in the LRP group died due to cardiovascular events. _x000D_

Conclusions

All along the 5-yr follow-up, the robotic approach allows for better functional results if compared to pure laparoscopic, without compromising oncological outcomes.

Funding

none