Researchers from Memorial Sloan-Kettering Cancer Center have reported that laparoscopic radical prostatectomy was as effective as radical open prostatectomy for the treatment of localized prostate cancer but with differing side effects. The details of this study appeared in an early online publication in the Journal of Urology on March 18, 2008.

Prostatectomy for localized prostate cancer can be performed by retropubic radical prostatectomy, laparoscopic prostatectomy, and more recently, by laparoscopic robotic techniques. The advantages of laparoscopic surgery included a smaller scar, less hospital time, and less blood loss. Although there have been no reported differences in cancer control, direct comparative studies are limited.

The current study was carried out in 1,430 consecutive patients between 2003 and 2005. Six-hundred-twelve patients opted for the laparoscopic procedure and 818 for retrospubic radical prostatectomy. The following observations were made after 18 months of surveillance:

• Positive margin rates, freedom from progression, and time to post operative potency were comparable between the two procedures.
• Patients undergoing laparoscopic prostatectomy were less likely to become continent and had higher readmissions and more emergency room visits.
• Patients undergoing open surgery had more blood loss: 49% were transfused compared with 3% following laparoscopic surgery.

Comments: These data should be helpful to patients who are about to undergo radical prostatectomy. Although control of cancer appears to be similar, there are differences in side effects of the two approaches.

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Reference: Touijer K, Eastham JA, Secin F, et al. Comprehensive prospective comparative analysis of outcomes between open and laparoscopic radical prostatectomy conducted in 2003 to 2005. Journal of Urology [early online publication]. March 18, 2008.