Comparison of Open Versus Robotically Assisted Cytoreductive Radical Prostatectomy for Metastatic Prostate Cancer
Standard
Comparison of Open Versus Robotically Assisted Cytoreductive Radical Prostatectomy for Metastatic Prostate Cancer. / Preisser, Felix; Nazzani, Sebastiano; Mazzone, Elio; Marchioni, Michele; Bandini, Marco; Tian, Zhe; Haese, Alexander; Saad, Fred; Zorn, Kevin; Montorsi, Francesco; Shariat, Shahrokh F; Graefen, Markus; Tilki, Derya; Karakiewicz, Pierre I.
in: CLIN GENITOURIN CANC, Jahrgang 17, Nr. 5, 10.2019, S. e939-e945.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Comparison of Open Versus Robotically Assisted Cytoreductive Radical Prostatectomy for Metastatic Prostate Cancer
AU - Preisser, Felix
AU - Nazzani, Sebastiano
AU - Mazzone, Elio
AU - Marchioni, Michele
AU - Bandini, Marco
AU - Tian, Zhe
AU - Haese, Alexander
AU - Saad, Fred
AU - Zorn, Kevin
AU - Montorsi, Francesco
AU - Shariat, Shahrokh F
AU - Graefen, Markus
AU - Tilki, Derya
AU - Karakiewicz, Pierre I
N1 - Copyright © 2019 Elsevier Inc. All rights reserved.
PY - 2019/10
Y1 - 2019/10
N2 - INTRODUCTION: Cytoreductive radical prostatectomy (CRP) may offer a survival advantage, according to several retrospective analyses. However, no direct comparisons are available regarding the type of surgical approach (open vs. robotic) in the metastatic setting. To address intraoperative and postoperative complications of robotically assisted CRP relative to open CRP in patients with metastatic prostate cancer.PATIENTS AND METHODS: Within the National Inpatient Sample database (2008-2013), we identified patients with metastatic prostate cancer who underwent robotically assisted versus open CRP. Multivariable logistic regression, multivariable Poisson regression models, and linear regression models were used.RESULTS: Of 874 patients who underwent CRP, 412 (47.1%) versus 462 (52.9%) underwent open versus robotically assisted CRP, respectively. Between 2008 and 2013, robotically assisted CRP rates increased from 7.6% to 50.0% (P = .5). In multivariable logistic regression models, robotically assisted CRP resulted in lower rates of overall (odds ratio [OR], 0.42; P < .001), miscellaneous medical (OR, 0.47; P = .02), and miscellaneous surgical complications (OR, 0.40; P = .04), as well as in lower rates of blood transfusions (OR, 0.19; P < .001). In multivariable Poisson regression models, robotically assisted CRP was associated with shorter stay (OR, 0.72; P < .001) and higher total hospital charges ($2483 more for each robotic surgery; P < .001). Similar results were recorded after adjustment for clustering.CONCLUSION: The intraoperative and postoperative complications associated with robotically assisted CRP are lower than those of open CRP. Similarly, robotically assisted CRP is associated with shorter stay. Conversely, an increase in total hospital charges is associated with robotically assisted CRP. Nonetheless, the complication profile of robotically assisted CRP validates its safety and feasibility.
AB - INTRODUCTION: Cytoreductive radical prostatectomy (CRP) may offer a survival advantage, according to several retrospective analyses. However, no direct comparisons are available regarding the type of surgical approach (open vs. robotic) in the metastatic setting. To address intraoperative and postoperative complications of robotically assisted CRP relative to open CRP in patients with metastatic prostate cancer.PATIENTS AND METHODS: Within the National Inpatient Sample database (2008-2013), we identified patients with metastatic prostate cancer who underwent robotically assisted versus open CRP. Multivariable logistic regression, multivariable Poisson regression models, and linear regression models were used.RESULTS: Of 874 patients who underwent CRP, 412 (47.1%) versus 462 (52.9%) underwent open versus robotically assisted CRP, respectively. Between 2008 and 2013, robotically assisted CRP rates increased from 7.6% to 50.0% (P = .5). In multivariable logistic regression models, robotically assisted CRP resulted in lower rates of overall (odds ratio [OR], 0.42; P < .001), miscellaneous medical (OR, 0.47; P = .02), and miscellaneous surgical complications (OR, 0.40; P = .04), as well as in lower rates of blood transfusions (OR, 0.19; P < .001). In multivariable Poisson regression models, robotically assisted CRP was associated with shorter stay (OR, 0.72; P < .001) and higher total hospital charges ($2483 more for each robotic surgery; P < .001). Similar results were recorded after adjustment for clustering.CONCLUSION: The intraoperative and postoperative complications associated with robotically assisted CRP are lower than those of open CRP. Similarly, robotically assisted CRP is associated with shorter stay. Conversely, an increase in total hospital charges is associated with robotically assisted CRP. Nonetheless, the complication profile of robotically assisted CRP validates its safety and feasibility.
KW - Aged
KW - Cytoreduction Surgical Procedures/methods
KW - Humans
KW - Length of Stay
KW - Logistic Models
KW - Male
KW - Middle Aged
KW - Prostatectomy/methods
KW - Prostatic Neoplasms/surgery
KW - Retrospective Studies
KW - Robotic Surgical Procedures/methods
KW - Survival Analysis
KW - Treatment Outcome
U2 - 10.1016/j.clgc.2019.05.022
DO - 10.1016/j.clgc.2019.05.022
M3 - SCORING: Journal article
C2 - 31375352
VL - 17
SP - e939-e945
JO - CLIN GENITOURIN CANC
JF - CLIN GENITOURIN CANC
SN - 1558-7673
IS - 5
ER -