"Excellent Long-Term Outcomes of Robotic Surgery in Third-Stage Prostate Cancer"

Seoul Asan Hospital Professors An Han-jong, Jeong In-gap, and Seo Jun-gyo Team
10-Year Metastasis-Free Survival Rate After Surgery, Same for Robotic and Open Surgery

Seoul Asan Hospital Department of Urology Professors An Han-jong, Jeong In-gap, Seo Jun-gyo.

[Asia Economy Reporter Lee Gwan-joo] A study has shown that robotic surgery demonstrates superior long-term outcomes even in stage 3 prostate cancer where the cancer has invaded the seminal vesicles.

The team of Professors An Han-jong, Jung In-gap, and Seo Jun-gyo from the Department of Urology at Seoul Asan Medical Center tracked patients with stage 3 prostate cancer who underwent either robotic or open surgery and reported on the 7th that there was no difference in the rate of survival without cancer metastasis over 10 years. This means that robotic surgery is as effective as open surgery in treating high-risk prostate cancer.

Prostate cancer is the most commonly treated cancer type with robotic surgery due to the prostate’s deep location in the pelvis, which makes securing a clear view and precise hand movements easier with robotic assistance. The seminal vesicles are located behind where the prostate meets the bladder and secrete fluid that makes up semen. Invasion of the seminal vesicles indicates that the cancer has spread beyond the capsule surrounding the prostate to adjacent tissues. This condition is classified as high-risk stage 3 prostate cancer.

The research team divided 510 patients with seminal vesicle-invasive prostate cancer who underwent radical prostatectomy between 2000 and 2012 at four domestic medical institutions (Seoul Asan Medical Center, Seoul National University Hospital, Samsung Seoul Hospital, Bundang Seoul National University Hospital) into a robotic surgery group (272 patients) and an open surgery group (238 patients). They then compared metastasis-free survival and recurrence-free survival rates at 5 and 10 years.

As a result, the 5-year metastasis-free survival rate was 82.1% in the robotic surgery group and 86.1% in the open surgery group. The 10-year metastasis-free survival rate was 66.7% in both groups, showing no significant difference. Additionally, the 5-year recurrence-free survival rate was 22.5% for the robotic surgery group and 20.5% for the open surgery group, while the 10-year recurrence-free survival rates were 13.9% and 11.6%, respectively, showing similar outcomes.

Robotic surgery allows precise operations by freely maneuvering robotic arms even within the narrow pelvis. It also suppresses bleeding during surgery, providing the surgeon with a clear view, and uses a 3D camera to display a magnified and depth-enhanced image. Notably, it is advantageous in preserving nerves and muscles compared to open surgery. This helps prevent complications such as erectile dysfunction and urinary incontinence, thereby improving patients’ quality of life after surgery. Being a minimally invasive surgery, it also results in less pain and scarring for patients and enables faster recovery.

However, robotic surgery is not yet covered by health insurance, so patients bear the burden of high surgical costs. Despite this, considering its many benefits, about 90% of prostate cancer surgeries currently performed in Korea are done using robotic surgery. At Seoul Asan Medical Center, more than 4,000 robotic surgeries were performed last year, with urology surgeries such as prostate and kidney cancer accounting for about 1,500 cases (approximately 33%), the highest number.

Professor An said, “Through this study, we confirmed that the long-term outcomes of robotic surgery in stage 3 prostate cancer, which is known to have a poor prognosis, are by no means inferior to those of open surgery. Further research is needed to thoroughly verify the effectiveness and safety of robotic surgery from various perspectives, including oncological outcomes, side effects, and patients’ quality of life.”

Professor Jung added, “Early screening is important for prostate cancer, as with other cancers. There are various early screening methods, among which the prostate-specific antigen (PSA) test is a simple blood test that can determine the presence of prostate cancer. We recommend that men over their 50s and men over their 40s with a family history undergo prostate cancer screening once a year, even if they have no symptoms.”

This study was conducted with the support of the Korean Society of Urologic Oncology, and the results were published in the latest issue of the international journal Journal of Cancer Research and Clinical Oncology.

This content was produced with the assistance of AI translation services.