“In the minimally invasive (MIRP) group over time, genitourinary complications and the need for blood transfusions decreased, perhaps signaling that surgeons were becoming more comfortable and increasingly successful with new robotic procedures,” said Dr. Kowalczyk.

While complications decreased with the minimally invasive procedure over time, in the group having traditional open surgery complication risks increased from 27.4% to 32% and included a significant increase in post-surgical death from 0.5% to 0.8%. Overall, men undergoing the minimally invasive procedure had a 0.2% risk of post-surgical death vs. a 0.6% risk in men undergoing the open procedure. Although the risk of death in both groups was quite small, this was still a statistically and potentially clinically significant difference between the two groups.

“We expected to see fewer complications as surgeons got more comfortable with minimally invasive procedures like robotics, but it remains somewhat of a mystery why the complication rates rose in the open surgery group. We statistically controlled for factors such as patient age and medical history, however men undergoing the open procedure were still more likely to experience more postoperative complications and mortality compared to the minimally invasive procedure. We think this warrants more study,” said Dr. Kowalczyk.

“The bottom line is that seeing an experienced surgeon is probably the most important variable when planning a safe and effective strategy to treat prostate cancer,” Dr. Kowalczyk said.

###
SOURCE MedStar Georgetown University Hospital