There Are No Differences in Positive Surgical Margin Rates or Biochemical Failure–Free Survival among Patients Receiving Open, Laparoscopic, or Robotic Radical Prostatectomy: A Nationwide Cohort Study from the National Cancer Database

SIMPLE SUMMARY: Few studies have evaluated oncologic outcomes in patients with prostate cancer (PC) receiving open, laparoscopic, or robotic radical prostatectomy (RP). To the best of our knowledge, this is the first and largest study to examine PSM and BFS rates in patients with PC undergoing open, laparoscopic, or robotic RP. After adjustment for confounders, no significant differences in PSM or BFS were noted among the patient groups. ABSTRACT: Purpose: To estimate the rates of positive surgical margin (PSM) and biochemical failure–free survival (BFS) among patients with prostate cancer (PC) receiving open, laparoscopic, or robotic radical prostatectomy (RP). Patients and Methods: The patients were men enrolled in the Taiwan Cancer Registry diagnosed as having PC without distant metastasis who received RP. After adjustment for confounders, logistic regression was used to model the risk of PSM following RP. After adjustment for confounders, Cox proportional regression was used to model the time from the index (i.e., surgical) date to biochemical recurrence. Results: The adjusted odds ratios (95% CIs) of PSM risk after propensity score adjustment for laparoscopic versus open, robotic versus open, and robotic versus laparoscopic RP 95% CIs were 1.25 (0.88 to 1.77; p = 0.2064), 1.16 (0.88 to 1.53; p = 0.2847), and 0.93 (0.70 to 1.24; p = 0.6185), respectively. The corresponding adjusted hazard ratios (95% CIs) of risk of biochemical failure after propensity score adjustment were 1.16 (0.93 to 1.47; p = 0.1940), 1.10 (0.83 to 1.47; p = 0.5085), and 0.95 (0.74 to 1.21; p = 0.6582). Conclusions: No significant differences in PSM or BFS were observed among patients receiving open, laparoscopic, or robotic RP.