Boston, Massachusetts (PressExposure) November 12, 2009 -- Rates of minimally invasive radical prostatectomy (MIRP) for men with prostate cancer have increased nearly five-fold in the years from 2001 to 2006 despite the lack of scientific evidence that MIRP is superior to the traditional, open retropubic radical prostatectomy approach (RRP). New research from Brigham and Women's Hospital (BWH) shows that while MIRP results in shorter hospital stays, it does not result in fewer complications overall. These findings are published in the October 14, 2009 issue of the Journal of the American Medical Association.
"There are advantages to each type of surgery," said Jim Hu, MD, a surgeon in the Urology Division at BWH and lead author of the paper. "Any man who is making the decision to undergo RRP or MIRP should talk with his surgeon about their level of experience performing each type of surgery and what the outcomes are."
Researchers compared tumor registry and Medicare linked data from nearly 9,000 men with prostate cancer who underwent either MIRP or RRP from 2003-2007 for various outcomes. They found that men who underwent MIRP experienced shorter hospital stays, were less likely to need a blood transfusion, had less post-operative respiratory complications and less anastomic stricture. However, these men also had more genitourinary complications, were more likely to be diagnosed with incontinence and erectile dysfunction. The need for additional cancer therapy did not differ by surgical approach.
Researchers note that surgeons have been performing RRP for approximately 30 years whereas MIRP has only been an option for the past 8 years and that the differences in outcomes may be related to the technical skill of the surgeon.
"As with any new procedure, there is a learning curve," said Hu. "This finding is based on an average of the outcomes of many surgeries performed by many different surgeons with different skill levels throughout the country."
This research was funded by a Department of Defense Prostate Cancer Physician Training Award.