How Robotic Surgery Helps Prostate-Cancer Patiets

By Jane Farrell

Prostate-cancer patients who have robotic-assisted surgery have less need for treatments such as hormone or radiation therapy, according to a new study.

Researchers from UCLA's Jonsson Comprehensive Cancer Center also found that the robotic-assisted surgery left fewer instances of cancer cells at the edge of the surgical specimen.

The study, published in the journal European Urology, was led by Dr. Jim Hu, director of robotic and minimally invasive surgery in the urology department at the David Geffen School of Medicine at UCLA.

Although robotic-assisted radical prostatectomy — the complete removal of the prostate – is becoming more common, it’s still controversial because there has been little evidence that it provides better cancer control than the less costly traditional surgical approach.

In the study, investigators compared 5,556 patients who received robotic surgery with 7,878 who underwent conventional surgery between 2004 and 2009. Those statistics were provided by the Surveillance, Epidemiology, and End Results–Medicare, a program of cancer registries that collect clinical and demographic information on people with cancer.

The researchers looked at the surgical margin status of the two groups, which is the amount of cancer cells at the edge of the removed prostate specimen. A positive margin — the presence of cancer cells at the edge — may result from leaving some cells behind rather than cutting around the cancer completely. That may lead to recurrence or death.

They found that robotic prostate surgery had 5 percent fewer positive margins (13.6 percent vs. 18.3 percent). The difference was greater for patients with intermediate and high-risk prostate cancer. Patients who had robotic surgery also had a one-third reduction in the likelihood of needing additional cancer therapies within 24 months after surgery.

Despite the greater up-front cost of robotic surgery, the findings show that the procedure may translate into less future costs and fewer side effects from radiation and hormone.