Background: Prostate cancer is a prominent form of cancer diagnosed in men living in developed countries, for which radical prostatectomy is a common frontline treatment. The aim of this systematic review was to determine whether robot-assisted laparoscopic radical prostatectomy (RALP) is more effective in the treatment of localised prostate cancer, compared to laparoscopic radical prostatectomy (LRP). Methods: An electronic search of Medline, Scopus, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials (Central) was performed up until December 2014. Randomised controlled trials (RCTs) that offered a direct comparison of laparoscopic and robotic techniques were eligible for inclusion in this review. Results: A total of 93 articles were identified through the literature search, of which 2 were included in this review. Meta-analysis of 2 studies identified a significantly higher rate of return of erectile function in the RALP group (relative risk (RR) 1.51; 95% confidence interval (CI) 1.19, 1.92). A similar effect was observed with return to continence function (RR 1.14; 95% CI 1.04, 1.24). Conclusions: This systematic review offers the first evaluation of evidence from RCTs with respect to the effectiveness of RALP and LRP in the treatment of localised prostate cancer. Preliminary results suggest that RALP was more efficient at preserving the erectile function and continence in comparison to LRP.

Keywords:
Prostate cancer, Systematic review, Prostatectomy, Laparoscopic, Robotic
1.
Baade PD, Youlden DR, Krnjacki LJ: International epidemiology of prostate cancer: geographical distribution and secular trends. Mol Nutr Food Res 2009;53:171-184.
3.
International Agency for Research on Cancer: GLOBOCAN 2012 estimated cancer incidence, mortality and prevalence worldwide in 2012. http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx.
4.
Ilic D, Misso M: Lycopene for the prevention and treatment of benign prostatic hyperplasia and prostate cancer: a systematic review. Maturitas 2012;72:269-276.
5.
Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, van der Kwast T, Mason M, Matveev V, Wiegel T, Zattoni F, et al: EAU Guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent - update 2013. Eur Urol 2014;65:124-137.
6.
Ficarra V, Novara G, Artibani W, Cestari A, Galfano A, Graefen M, Guazzoni G, Guillonneau B, Menon M, Montorsi F, et al: Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies. Eur Urol 2009;55:1037-1063.
7.
Cathcart P, Murphy DG, Moon D, Costello AJ, Frydenberg M: Perioperative, functional and oncological outcomes after open and minimally invasive prostate cancer surgery: experience from Australasia. BJU Int 2011;107(suppl 3):11-19.
8.
Stacey D, Légaré F, Col NF, Bennett CL, Barry MJ, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Thomson R, et al: Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2014;1:CD001431.
9.
Parsons JK, Bennett JL: Outcomes of retropubic, laparoscopic, and robotic-assisted prostatectomy. Urology 2008;72:412-416.
10.
Higgins J, Green S (eds): Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0. The Cochrane Collaboration, 2011.
11.
Asimakopoulos AD, Pereira Fraga CT, Annino F, Pasqualetti P, Calado AA, Mugnier C: Randomized comparison between laparoscopic and robot-assisted nerve-sparing radical prostatectomy. J Sex Med 2011;8:1503-1512.
12.
Porpiglia F, Morra I, Lucci Chiarissi M, Manfredi M, Mele F, Grande S, Ragni F, Poggio M, Fiori C: Randomised controlled trial comparing laparoscopic and robot-assisted radical prostatectomy. Eur Urol 2013;63:606-614.
13.
Coelho RF, Rocco B, Patel MB, Orvieto MA, Chauhan S, Ficarra V, Melegari S, Palmer KJ, Patel VR: Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a critical review of outcomes reported by high-volume centers. J Endourol 2010;24:2003-2015.
14.
Doumerc N, Yuen C, Savdie R, Rahman MB, Rasiah KK, Pe Benito R, Delprado W, Matthews J, Haynes AM, Stricker PD: Should experienced open prostatic surgeons convert to robotic surgery? The real learning curve for one surgeon over 3 years. BJU Int 2010;106:378-384.
15.
Secin FP, Savage C, Abbou C, de La Taille A, Salomon L, Rassweiler J, Hruza M, Rozet F, Cathelineau X, Janetschek G, et al: The learning curve for laparoscopic radical prostatectomy: an international multicenter study. J Urol 2010;184:2291-2296.
16.
Eden CG, Neill MG, Louie-Johnsun MW: The first 1000 cases of laparoscopic radical prostatectomy in the UK: evidence of multiple ‘learning curves'. BJU Int 2009;103:1224-1230.
17.
Vickers AJ, Savage CJ, Hruza M, Tuerk I, Koenig P, Martínez-Piñeiro L, Janetschek G, Guillonneau B: The surgical learning curve for laparoscopic radical prostatectomy: a retrospective cohort study. Lancet Oncol 2009;10:475-480.
18.
Barocas DA, Mitchell R, Chang SS, Cookson MS: Impact of surgeon and hospital volume on outcomes of radical prostatectomy. Urol Oncol 2010;28:243-250.
19.
Gardner TA, Bissonette EA, Petroni GR, McClain R, Sokoloff MH, Theodorescu D: Surgical and postoperative factors affecting length of hospital stay after radical prostatectomy. Cancer 2000;89:424-430.
© 2015 S. Karger AG, Basel
2015
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.