Outcomes - Robot-Assisted Radical Prostatectomy

Robot-Assisted Radical Prostatectomy (prostate removal)
Outcomes are the results of surgery.  There are a number of things that are considered when looking at how successful a particular operation has been.  These include how quickly you recover, the likelihood of curing the cancer and the chance of long-term side effects.
Since the Robotic Center at RPCI opened in 2004, almost 100% of radical prostate operations have been done robotically. RPCI’s outcomes data for robot-assisted prostatectomy, including data on cancer control and adverse effects, are benchmarked against national averages for both robot-assisted and open radical prostatectomy.

What are Surgical Margins?
After the prostate is removed, pathologists look at the edges (margins) of the tissue to see if there are cancer cells there. If there is cancer in these margins (positive margins), it may mean that not all of the cancer was removed during surgery.
 

Surgical Margins: RPCI and Henry Ford Health System Comparative Analysis

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At Henry Ford Health System, in patients whose tumors were restricted to the prostate (stage T2), 13% had positive margins. In patients whose tumors had spread beyond the prostate (stage T3), 35% had positive margins. At RPCI, 12% of stage T2 patients had positive margins and 32% of stage T3 patients had positive margins.

Adjuvant Therapy

The graph shows the incidence of RPCI patients who required additional treatments after surgery, compared to national averages based on SEER-Medicare calculations.

References:
1. Hu JC, Gu X, Lipsitz SR et al. Comparative effectiveness of minimally invasive vs open radical prostatectomy. JAMA 2009;302(14):1557-1564.
2. Badani K, Kaul S, Menon M: Evolution of robotic radical prostatectomy: Assessment after 2766 procedures. Cancer 2007;110(9), 1951-1958.

Preserving Erectile Function (Cases)

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The nerves that help the penis become erect are about 3mm (1⁄8 inch) away from the prostate. At RPCI, the incidence of extra surgery for the treatment of erectile function following robot-assisted radical prostatectomy is 0.3 per “100 person-years.”

Reference:
1. Hu JC, Gu X, Lipsitz SR et al. Comparative effectiveness of minimally invasive vs open radical prostatectomy JAMA 2009;302(14):1557-1564.

Urinary Incontinence

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The incidence of incontinence at RPCI after robot-assisted radical prostatectomy was 11.1 compared to 15.9 (minimally invasive) and 12.2 (open radical) per “100 person-years” based on SEER-Medicare calculations.

Reference:
1. Hu JC, Gu X, Lipsitz SR et al. Comparative effectiveness of minimally invasive vs open radical prostatectomy JAMA 2009;302(14):1557-1564.