Review Article

Efficacy of Robotic-Assisted Prostatectomy in Localized Prostate Cancer: A Systematic Review of Clinical Trials

Table 1

Characteristics of studies included in the review.

Authors, yearSelection criteriaGroupsCharacteristics

Guazzoni et al., 2006 [16]Inclusion: men with prostate cancer <70 years, with clinically localized disease (cT1-cT2), serum PSA < 20 ng/mL, Gleason score ≤ 7
Exclusion: previous hormone blocking or previous prostate, bladder neck, urethra, or pelvic surgery; total prostate gland volume ≥ 60 mL
Group 1: radical retropubic prostatectomy (RRP), 60 patients
Group 2: radical laparoscopic prostatectomy (RLP), 60 patients
Single surgeon trial: surgeon had 15 years of experience performing open prostatectomy and more than 150 laparoscopic procedures

Asimakopoulos et al.,  2011 [17]Inclusion: men with clinically localized prostate cancer (cT1-cT2), <70 years, serum PSA < 10 ng/mL, Gleason score ≤ 7, normal preoperative erectile function (IIEF-6 > 17), normal preoperative continence (IPSS)
Exclusion: preoperative incontinence, moderate or severe erectile dysfunction (IIEF 6 < 17), neoadyuvant therapy, previous prostate, bladder neck or urethra surgery, positive MRI for extracapsular extension, nonbilateral nerve preservation
Group 1: radical laparoscopic prostatectomy (RLP), 64 patients
Group 2: radical robotic-assisted laparoscopic prostatectomy (RRALP), 64 patients
(i) Single surgeon trial, with 900 conventional laparoscopic prostate resections and 300 robotic-assisted prostatectomies
(ii) Continence was defined as absence of leakage or no need of use of protective pads
(iii) Potency was defined as “capability of intercourse” and as an IIEF-6 scale score equal to or greater than 17, with or without the use of phosphodiesterase type 5 inhibitors
(iv) Biochemical recurrence definition was not reported

Porpiglia et al., 2013 [18]Inclusion: men with clinically localized prostate cancer according to TNM 2009 (T1-T2N0M0), remitted to institution for prostatectomy; between 40 and 70
Exclusion: previous radiotherapy and/or transurethral resection of the prostate gland
Group 1: radical laparoscopic prostatectomy (RLP), 64 patients
Group 2: radical robotic-assisted laparoscopic prostatectomy (RRALP), 64 patients
(i) Single surgeon trial, with a reported experience of more than 600 laparoscopic prostatectomies and 100 robotic prostatectomies
(ii) Continence was defined as the requirement of one or less safety pads per day
(iii) Potency was defined as having an IIEF-5 scale score equal to or greater than 17
(iv) Biochemical recurrence was defined as PSA > 0.2 ng/mL

IIEF: International Index of Erectile Function; IPSS: International Prostate Symptom Score; MRI: magnetic resonance imaging.