Laparoscopic versus Robotic-Assisted Radical Prostatectomy for the Treatment of Localised Prostate Cancer: A Systematic Review

Abstract

BACKGROUND: Prostate cancer is a prominent form of cancer diagnosed in men living in developed countries, for which radical prostatectomy is a common frontline treatment. The aim of this systematic review was to determine whether robot-assisted laparoscopic radical prostatectomy (RALP) is more effective in the treatment of localised prostate cancer, compared to laparoscopic radical prostatectomy (LRP). METHODS: An electronic search of Medline, Scopus, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials (Central) was performed up until December 2014. Randomised controlled trials (RCTs) that offered a direct comparison of laparoscopic and robotic techniques were eligible for inclusion in this review. RESULTS: A total of 93 articles were identified through the literature search, of which 2 were included in this review. Meta-analysis of 2 studies identified a significantly higher rate of return of erectile function in the RALP group (relative risk (RR) 1.51; 95% confidence interval (CI) 1.19, 1.92). A similar effect was observed with return to continence function (RR 1.14; 95% CI 1.04, 1.24). CONCLUSIONS: This systematic review offers the first evaluation of evidence from RCTs with respect to the effectiveness of RALP and LRP in the treatment of localised prostate cancer. Preliminary results suggest that RALP was more efficient at preserving the erectile function and continence in comparison to LRP.