A clinical evaluation of robotic-assisted radical prostatectomy (RARP) in located prostate cancer: A systematic review and network meta-analysis

Abstract

Prostate cancer (PCa) is a prevalent malignant tumor affecting the male reproductive system and there are mainly three widely accepted PCa surgery types in current clinical treatment: open radical prostatectomy (ORP), laparoscopic radical prostatectomy (LRP) and robot-assisted radical prostatectomy (RARP). Here, we aimed to evaluate the clinical effect of RARP for PCa patients compared with ORP and LRP based on the context of PCa encompass two dimensions: oncological outcomes (biochemical recurrence (BCR) and positive surgical margin (PSM)) and functional outcomes (urinary continence and recovery of erectile function) in this network meta-analysis (NMA). PubMed, Embase and Cochrane databases were systematically searched in January 7, 2024. 4 randomized controlled trials (RCTs) and 72 non-RCTs were included. RARP displayed significant positive effect on lower BCR and better recovery of erectile function but no significant differences existed among three surgery types for PSM and urinary continence. • It is the first network meta-analysis focused on assessing the therapeutic outcomes among different radical prostatectomy approaches. • In this systematic review and network meta-analysis, robot-assisted radical prostatectomy (RARP) was observed promising advantages in lower rate of biochemical recurrence and positive surgical margins as well as better urinary continence and recovery of erectile function compared with open radical prostatectomy (ORP) and laparoscopic radical prostatectomy (LRP). • RARP was recommended as the first choice for patients with prostate cancer.