04/13/2010 - News

Laparoscopy No Better Than Open Surgery for Prostate Cancer

By: June Chen, MD


Open radical prostatectomy is considered the standard treatment for prostate cancer. However, minimally-invasive surgical procedures for prostate cancer are becoming more popular even though there is limited evidence that these surgeries result in better outcomes than open radical prostatectomy. In the April 2010 issue of Journal of Urology, researchers report that laparoscopic prostate cancer removal and open prostate cancer removal have similar rates of complications.

Researchers from the Memorial Sloan-Kettering Cancer Center in New York looked at post-operative outcomes of both open radical prostatectomy and laparoscopic radical prostatectomy, both with and without robotic assistance. The study included nearly 6000 men over the age of 65 with localized prostate cancer. The researchers found similar rates of success between these types of surgery for prostate cancer removal. There were no differences in the rate of general medical or surgical complications or in the rate of urinary or bowel complications. There was also no difference in the need for medical treatment such as radiation or androgen deprivation. Laparoscopic procedures for prostate cancer removal were associated with a 35% shorter hospital stay, especially when the surgeon had more experience with the procedure.

Each year in the United States, an estimated one-third of the 200,000 men newly diagnosed with prostate cancer opt to undergo surgical treatment. It seems that many patients with prostate cancer have the perception that robot-assisted prostatectomy is superior, despite the clinical trial evidence. According to this study, patients with localized prostate cancer should be advised by their physicians of the expected benefits and risks of each surgical technique in order to facilitate decision-making and set realistic expectations regarding outcomes.



Journal of Urology 2010; 183(4): 1366-1372.


Created on: 04/13/2010
Reviewed on: 04/13/2010

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DoubleDean wrote 1 year 45 weeks ago

I had a radical prostatectomy on 4/7/10. I had the open procedure and would highly recommend it over robotic. I am 61 years old. The recovery time for the open procedure could hardly have been shorter. The surgery was on Wednesday. I was released from the hospital on Friday at noon and started back to work Monday morning. I have worked full time since then with the only discomfort being that of the catheter, not from the surgery. More importantly, the doctor never knows exactly what he/she is going to find until they open you up. In my case, with the various things he had to do and decisions he had to make, robotic would have been very challenging and would have taken a lot longer. More importantly, he would not have the "feel" with robotic which guided him in making the decisions he had to make.

Anonymous wrote 1 year 46 weeks ago

You nice research providing the cancer treatment, I think both technique are useful in cancer treatment.

Anonymous wrote 1 year 46 weeks ago

All other things being equal, I'm not sure how less pain and shorter recovery times do not qualify as better outcomes. As the one feeling that pain, this is not an inconsequential detail. Other studies also seem to indicate that minimally invasive techniques with their smaller incisions and reduced time in the hospital result in reduced chance of infection, which is a growing concern across all types of surgery.