Open Access

ARTICLE

Robotic prostatectomy versus brachytherapy for the treatment of low risk prostate cancer

Claudio Giberti, Fabrizio Gallo, Maurizio Schenone, Emilio Gastaldi, Pierluigi Cortese, Gaetano Ninotta, Davide Becco

Department of Urology, San Paolo Hospital, Savona, Italy
Address correspondence to Dr. Fabrizio Gallo, Department of Urology, San Paolo Hospital, Via Genova 30, 17100 Savona - Italy

Canadian Journal of Urology 2017, 24(2), 8728-8733.

Abstract

Introduction: To compare oncological and functional results of robot-assisted radical prostatectomy (RARP) and brachytherapy (BT) with a single-center prospective randomized study.
Materials and methods: From January 2012 to January 2014, 165 patients with low risk prostate cancer, prostate volume ≤ 50 g, normal urinary (IPSS ≤ 7 and mean flow rate ≥ 15 mL/sec) and erectile functions (IIEF-5 > 17) were enrolled and randomly assigned to the RARP or BT group. Our end points included the comparison of biochemical recurrence-free survival rates, urinary function (IPSS and EPIC scores) and potency rates (IIEF-5 score) at different time points during the first 2 years after surgery between the two groups.
Results: The biochemical recurrence-free survival rates were 96.1% and 97.4% for the BT and RARP groups, respectively (p = 0.35). Significantly higher IPSS scores were assessed in the BT than in the RARP group at all the postoperative time points (p < 0.05). Significantly higher continence rates were assessed in the BT than in the RARP group during only the first 6 months of follow up (p < 0.05). Significantly lower potency rates were assessed in the BT than in the RARP group at all the postoperative time points (p < 0.05).
Conclusions: Our data showed similar biochemical recurrence-free survival rates after BT and RARP. BT patients confirmed constantly higher rates of urinary symptoms while only reporting better continence rates for the first 6 months after surgery. RARP patients reported higher potency rates than BT patients during all the follow up period.

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