Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Few differences in outcomes between open and laparoscopic prostate surgery

22.02.2010
According to new study published in the Journal of Urology

Of the 200,000 men newly diagnosed with prostate cancer each year in the United States, about one-third will undergo surgical treatment. Although open radical prostatectomy (ORP) is regarded as the standard treatment, laparoscopic radical prostatectomy (LRP) with or without robotic assistance is becoming more common.

In a study published online today in The Journal of Urology, researchers from the Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, examined the postoperative outcomes of both ORP and LRP and found similar rates of success. They advise that men considering prostate cancer surgery should understand the expected benefits and risks of each technique to facilitate decision making and set realistic expectations.

Enthusiasm for LRP, specifically for LRP with robotic assistance, has grown rapidly despite limited evidence of its superiority to ORP. While most studies to date have been based on a limited number of patients or from single institutions, the authors of the current study compared ORP and LRP outcomes in a population based cohort of almost 6000 men 66 years of age or older with clinically localized prostate cancer, controlling for patient and tumor characteristics, and examined the impact of surgeon volume in men treated with LRP.

Dr. Yair Lotan, Department of Urology, University of Texas Southwestern Medical Center, Dallas, comments on the study, "A concern of these authors is the perception among patients that the robotic approach to prostatectomy is significantly superior. This perception is often reinforced by advertising from industry and physicians. Patients deserve to have a realistic expectation of surgical outcomes, especially considering the multiple other available treatment options. Notably the main information that a patient must know is not the prostatectomy approach but surgeon experience. Several studies show that the primary determinant of prostatectomy outcome is surgical volume. Patients should be educated on likely outcomes of a procedure based on individual surgeon experience. Unfortunately this information is often harder to obtain than published reports from experts in the field."

After adjusting for patient and tumor characteristics, there were no differences in the rate of general medical/surgical complications or genitourinary/bowel complications, or in postoperative radiation and/or androgen deprivation. LRP was associated with a 35% shorter hospital stay and a lower bladder neck/urethral obstruction rate. In laparoscopic cases, the surgeon's experience with the procedure was inversely associated with hospital stay and the odds of any genitourinary/bowel complication.

Writing in the article, William T. Lowrance, MD, and colleagues state, "Results suggest that ORP and LRP have similar rates of postoperative mortality and morbidity. Controlling for important patient and tumor characteristics, the only differences favoring LRP were shorter length of stay and a lower risk of bladder neck or urethral obstruction. All men considering radical prostatectomy should be clearly informed about the differences between the 2 techniques and similarities in their expected outcomes, and make treatment decisions in collaboration with an experienced surgeon."

The article is "Comparative Effectiveness of Prostate Cancer Surgical Treatments: A Population Based Analysis of Postoperative Outcomes" by William T. Lowrance, Elena B. Elkin, Lindsay M. Jacks, David S. Yee, Thomas L. Jang, Vincent P. Laudone, Bertrand D. Guillonneau, Peter T. Scardino and James A. Eastham. It is published online (DOI:10.1016/j.juro.2009.12.021) and will appear in The Journal of Urology, Volume 183 Issue 4 (April 2010) published by Elsevier.

Linda Gruner | EurekAlert!
Further information:
http://www.elsevier.com

More articles from Studies and Analyses:

nachricht New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg

nachricht Disarray in the brain
18.12.2017 | Universität zu Lübeck

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Artificial agent designs quantum experiments

On the way to an intelligent laboratory, physicists from Innsbruck and Vienna present an artificial agent that autonomously designs quantum experiments. In initial experiments, the system has independently (re)discovered experimental techniques that are nowadays standard in modern quantum optical laboratories. This shows how machines could play a more creative role in research in the future.

We carry smartphones in our pockets, the streets are dotted with semi-autonomous cars, but in the research laboratory experiments are still being designed by...

Im Focus: Scientists decipher key principle behind reaction of metalloenzymes

So-called pre-distorted states accelerate photochemical reactions too

What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...

Im Focus: The first precise measurement of a single molecule's effective charge

For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.

Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...

Im Focus: Paradigm shift in Paris: Encouraging an holistic view of laser machining

At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.

No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...

Im Focus: Room-temperature multiferroic thin films and their properties

Scientists at Tokyo Institute of Technology (Tokyo Tech) and Tohoku University have developed high-quality GFO epitaxial films and systematically investigated their ferroelectric and ferromagnetic properties. They also demonstrated the room-temperature magnetocapacitance effects of these GFO thin films.

Multiferroic materials show magnetically driven ferroelectricity. They are attracting increasing attention because of their fascinating properties such as...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

10th International Symposium: “Advanced Battery Power – Kraftwerk Batterie” Münster, 10-11 April 2018

08.01.2018 | Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

 
Latest News

Let the good tubes roll

19.01.2018 | Materials Sciences

How cancer metastasis happens: Researchers reveal a key mechanism

19.01.2018 | Health and Medicine

Meteoritic stardust unlocks timing of supernova dust formation

19.01.2018 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>