Comparison of outcomes of robot-assisted vs. open or laparoscopic of radical prostatectomy: a population-based cohort study

Abstract

We studied perioperative outcomes, postoperative complications, and survival rates for open radical prostatectomy (ORP), laparoscopic radical prostatectomy (LRP) and robot-assisted radical prostatectomy (RARP). Taiwan's entire 2018-2021 National Health Insurance Research Database (NHIRD) was linked with the cancer registration file to conduct a retrospective cohort study. A total of 4883 patients with localized (or locally advanced) prostate cancer (PCa) who underwent ORP, RARP, or LRP from 2018 to 2021 were analyzed. Differences in patient characteristics and perioperative outcomes were assessed before and after inverse probability of treatment weighting (IPTW). RARP accounted for 91.3% of the surgeries, followed by LRP (4.7%) and ORP (4.3%). ORP and LRP were associated with higher blood transfusion rates, longer hospital stays, and ICU admissions compared with RARP. Post-IPTW, RARP exhibited significantly lower rates of perioperative complications and postoperative readmissions compared with ORP and LRP. The postoperative risk profile for RARP was lower compared with those for ORP and LRP.