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    Study: Robotic RP yields fewer positive margins

    Prostate cancer patients who undergo robot-assisted radical prostatectomy have fewer positive surgical margins and less need for additional cancer treatments such as hormone or radiation therapy than patients undergoing open surgery, an observational study from UCLA’s Jonsson Comprehensive Cancer Center has found.

    The study appears online in European Urology (Feb. 19, 2014).

    In an effort to determine whether or not robotic surgery offered an advantage, first author Jim Hu, MD, MPH, and colleagues compared 5,556 patients who received robotic surgery with 7,878 who underwent open surgery between 2004 and 2009. Data were provided by the Surveillance, Epidemiology, and End Results–Medicare database.

    The researchers assessed the surgical margin status and the use of additional cancer therapies—androgen deprivation and radiation—after robotic surgery and open surgery. They found that robotic prostatectomy was associated with 5% fewer positive margins (13.6% vs. 18.3%); this difference was greater for patients with intermediate- and high-risk prostate cancer.

    Patients who had robotic surgery also had a one-third reduction in the likelihood of needing additional cancer therapies within 24 months after surgery.

    “Although robot-assisted radical prostatectomy (RARP) is more costly than open radical prostatectomy, our population-based study demonstrates that RARP is associated with fewer positive surgical margins and less use of additional cancer therapy within 2 years postoperatively,” Dr. Hu and colleagues wrote.

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    • Dr. steve
      How important are these positive margins in determining long range outcomes?


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