In a world first trial Australian researchers have found robotic surgery for prostate cancer is no more effective than open prostatectomy at 12 weeks after surgery, contrary to widespread clinical advice.
Robot-assisted surgery for prostate cancer has been rapidly adopted by health professionals over the past 16 years and is now the dominant surgical approach for prostatectomy – a surgical operation to remove the prostate gland when cancer is found.
Lead investigator on the study, Professor Robert ‘Frank’ Gardiner AM from the University of Queensland and the Royal Brisbane and Women’s Hospital, said the study examined surgery outcomes for more than 300 Australian men, with follow-up on post-operative outcomes over 12 weeks.
“Our research found no significant statistical differences between the robotic approach and open surgery for urinary control, erectile function and cancer outcomes at the early time-point of 12 weeks’ follow-up,” Prof Gardiner said.
“Surgery has long been the dominant approach for the treatment of localised prostate cancer, with many clinicians now recommending the robotic method to patients.
“Clinicians claim the benefits of robotic technology lead to improved quality of life and oncological outcomes – but our randomized clinical trial, the first of its kind, has found no statistical difference in oncological outcomes between the two groups at this early time-point.”
Menzies Foundation Professor of Allied Health Research, Professor Suzanne Chambers, said men were often confused by the range of management options available for the disease.
“At 12 weeks, these two surgical approaches yielded similar outcomes for prostate cancer patients,” Prof Chambers said.
“Both approaches showed good early results. There was no difference in urinary, sexual and bowel function at six and 12 weeks post-surgery, and return to work time did not differ.
“We are engaged in longer follow-up research, and plan to publish further findings after the final patient has completed his two-year follow-up assessment.
“In the interim, we encourage patients to ask about all their treatment options, consider the pros and cons of each, and make an informed decision about what treatment approach is best for them.”
Cancer Council Queensland spokesperson Katie Clift said prostate cancer was the most commonly diagnosed cancer in Queensland.
“Around 4000 men are diagnosed with prostate cancer every year in Queensland, and about 630 die from the disease,” Ms Clift said.
“Queensland men should visit their GP to discuss their individual risk of prostate cancer, and the pros and cons of prostate cancer testing.”
The study, published this week in The Lancet, was funded by Cancer Council Queensland and undertaken by the Department of Urology at Royal Brisbane & Women’s Hospital, Menzies Health Institute Queensland, and University of Queensland Centre for Clinical Research with support from the Urological Society of Australia and New Zealand
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