Division of Urology

Robotic Prostatectomy - Patient Outcomes

For More Information

This table represents a selection of recently published reports from institutions specializing in radical prostatectomy using the open, laparoscopic and robot assisted techniques.

Publication	Technique	Number of patients	Positive Margins* (%)	Mean Follow-up** (months)	Cancer-free*** (No detectable PSA) (%)
Han et al⁴	Open	9035	14.7
Lepor et al⁵	Open	1000	19.9
Zincke et al⁶	Open	3170	24	60	52 @ 10 yrs
Hull et al⁷	Open	1000	12.8	53	75
Iselin et al⁸	Open	1242	23	60	Organ confined 92 Specimen confined 65 Positive margin 35
Rassweiler et al⁹	Laparoscopic	450	18.6	23	91
Ruiz et al¹⁰	Laparoscopic	330	26
Guilloneau et al¹¹	Laparoscopic	1000	19.2	12	90.5
Tewari et al¹²	Robotic	530	9	6	92
Patel et al¹³	Robotic	500	9.4	9.7	95
Borin et al¹⁴	Robotic	299	13.7	7.6	93

*Margins refer to the presence or absence of cancer at the edges of the prostate specimen after it has been surgically removed. Positive Margins mean that not all the cancer was removed at the time of surgery. A negative margin means that all the visible cancer was removed. A positive margin may occur because the cancer has already spread beyond the prostate and could not have been completely removed by surgery or it may indicate that not enough of the tissue surrounding the prostate was removed. Usually this tissue is near the nerves that control erection or the urinary sphincter which controls continence. The presence of positive margins places a patient at higher risk for eventual recurrence of cancer. Robotic surgeons may be able to reduce the risk of positive margins, while still preserving the nerves and sphincter, using the superior 3-D vision and 10 times magnification available in the robotic camera. These series of robot assisted prostatectomies had similar or better rates of positive margins as compared to the laparoscopic or open approach.

**Follow-up refers to the length of time after surgery for which each study tracked the outcomes of patients. The large series of open prostatectomies have much longer follow-up times (around 5 years) because this is an older technique that has been used for the past 20 years. The follow-up available for laparoscopic and robotic surgeries is much shorter (1-2 years) because these techniques are much newer.

***Cancer-free rates refer to the percentage of patients in each study who remained cancer free after surgery. In general, cancer-free means that the PSA remains undetectable (zero). Even patients who have a perfect surgery with negative margins are at some risk for cancer recurrence depending on their pre-operative PSA, Gleason score, and the amount of cancer present. The series of open prostatectomy have lower cancer-free rates because the patients were followed for a longer period of time. The cancer-free rates of the laparoscopic and robotic series are based on much shorter periods of follow-up. However, these suggest that in appropriately selected patients, the majority (over 90%) will have no evidence of cancer within the first year after surgery.

This page was last updated on: August 16, 2007.

For more information, call the University Physicians Consultation and Referral Service at 1-800-492-5538 (patients) or 1-800-373-4111 (physicians).