The Results Are In: Do Robotic Prostatectomies Work?

In the October 2007 edition of the journal Cancer, the first article reviewing five years of data on robotic prostatectomies was published. This is a landmark paper in the field of robotic surgery and prostate cancer. Dr. Mani Menon, a urologist at Henry Ford Hospital, senior authored this paper reviewing his experience of 2,766 men who underwent a robot-assisted prostatectomy. The average patient age was 60 years old and mean prostate specific antigen (PSA) was 6.4 ng/ml. Of these men, 64% had Gleason 7 adenocarcinoma of the prostate at the time of surgery. The estimated blood loss was only 100 cc (about 3-4 fluid ounces). Almost 97% of patients were discharged to home the day following surgery.

At 5 years, biochemical free survival was 84%. This means that 84% of men had no rise of their PSA 5 years after surgery or only 16% have failed the surgical attempt at cure. This is an extremely important statistic. It has been demonstrated in previous studies that up to 1/3 (33%) of all men undergoing protate cancer treatment - whether it be surgery, seed implant, external beam radiation or hormones - will fail that therapy. The first sign that treatment is failing is a steady rise in the PSA value. This rise of PSA after treatment is called biochemical failure. This study demonstrates one of the lowest biochemical failure rates in history.

Personally, this is a very important article in my career because it was about five years ago when urologists were skeptical about robotic surgery and its role in treating prostate cancer. I can recall sitting at meetings and conferences with other urologists discussing this "new surgery performed with a robot". Almost everyone in the room would say, "we'll have to wait for the data to see if it is as good as open surgery." Well, that data is starting to emerge and those questions are being answered. Further studies will be completed as this surgical technique continues to evolve.

Does robotic surgery offer better cancer controlling rates compared to open surgery? Does the ability to see the prostate anatomy with robotic technology improve cancer control? The data says YES.

Speak with your physician about the right treatment for you or your loved one, but it is important to be knowledgeable about the data and research available. This article and the data it analyzes are important to consider when evaluating treatment options for prostate cancer.