Robot-assisted prostate cancer surgery yields positive results

There have been plenty of reports on the dangers of robot-assisted surgery, but here's some good news out of the University of California at Los Angeles--robotic-assisted prostate surgery offered better cancer control than traditional "open" surgery in a trial.

The study, published in journal European Urology, compared 5,556 patients who underwent robotic surgery with 7,878 who underwent open surgery between 2004-2009, supported by data from a Medicare program of cancer registries that collect clinical and demographic data.

The researchers, according to an announcement from UCLA, looked at the amount of cancer cells at the edge of the removed prostate specimen. As the announcement explained, a positive margin, with the presence of cancer cells at the edge, may result from cutting through the cancer and leaving some behind. This can result in a greater risk of relapsing and dying from the disease.

Robotic surgery was associated with 5 percent fewer positive margins, and a one-third reduction in needing additional therapy within 24 months after surgery.

"Despite the greater up-front cost of robotic surgery, the findings show that the procedure may translate into less downstream costs and fewer side effects from radiation and hormone therapy," the researchers concluded.

A study published last August in the Journal for Healthcare Quality by researchers from Johns Hopkins University School of Medicine found complications from robotic surgery to be widely underreported.

In March of last year, the American Congress of Obstetricians and Gynecologists said that robotic surgery for hysterectomies should not be a first or even second choice for women undergoing routine procedures, due, in part, to the learning curve associated with the robotic system. That same month, health officials in Massachusetts sent a letter outlining safety concerns about robotic surgery after two damaging incidents involving robots performing hysterectomies.

The U.S. Food and Drug Administration currently is surveying hospitals on complications, outcomes and dangers with Intuitive's da Vinci robot.

To learn more:
- read the announcement from UCLA
- see the study abstract in European Urology

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