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Fewer Positive Margins With Robot-Assisted Prostatectomy

THURSDAY, March 6, 2014 (HealthDay News) -- Robot-assisted radical prostatectomy (RARP) is associated with improved surgical margin status compared with open radical prostatectomy (ORP) for intermediate- and high-risk disease and with less use of additional cancer therapy, according to a study published online March 4 in European Urology.

Jim C. Hu, M.D., from the David Geffen School of Medicine at University of California Los Angeles, and colleagues examined the comparative effectiveness of RAPR and ORP. The retrospective study used Surveillance Epidemiology and End Results-Medicare linked data for 5,556 RARP and 7,878 ORP cases from 2004 to 2009.

The researchers found that RARP correlated with fewer positive surgical margins (13.6 versus 18.3 percent; odds ratio [OR], 0.70). This was largely due to fewer positive surgical margins for intermediate- and high-risk disease (ORs, 0.66 and 0.70, respectively). In addition, less use of additional cancer therapy was seen with RAPR within six, 12, and 24 months of surgery (ORs, 0.75, 0.73, and 0.67, respectively). Biochemical recurrence could not be ascertained due to the absence of prostate-specific antigen levels.

"RARP is associated with improved surgical margin status relative to ORP for intermediate- and high-risk disease and less use of postprostatectomy androgen deprivation therapy and radiotherapy," the authors write. "This has important implications for quality of life, health care delivery, and costs."

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