Single-, Multi-Port RARP Platforms Provide Similar Outcomes

A retrospective review presented at the 24th Annual Meeting of the Society of Urologic Oncology compared approaches for robotic radical prostatectomy (RARP) between single-port (SP) and multi-port (MP) platforms. The findings showed that SP and MP robotics may provide similar outcomes.

The introduction of SP robotic platforms has resulted in the development of a more regionalized approach to RARP. Despite the benefits provided by this approach, such as enhanced recovery with same-day discharge, there is limited evidence on the impact of SP robotic platforms on pathologic and oncologic outcomes. Dr. Nicolas A. Soputro and colleagues sought to evaluate the impact.

Data were prospectively collected from 169 patients who underwent SP transvesical or MP transperitoneal RARP performed by a single surgeon between 2015 and 2022. Each SP case was completed from within the bladder. The preoperative clinicopathologic characteristics and final histopathology outcomes of each patient were compared. Univariate Cox proportional hazard analysis was used to evaluate the impact of the surgical approach on biochemical recurrence-free survival within 12 months.

SP transvesical RARP was completed in 85 patients, while 84 patients underwent MP transperitoneal RARP. The preoperative clinicopathologic and prostatectomy histopathologic outcomes were similar between both patient groups, and both surgical approaches had similar positive surgical margin rates (SP, 20% vs MP, 26%; P=.36).

At a median follow-up of 12 months, no differences were found in the rates of biochemical recurrence between the SP and MP groups (P=.38). A univariate Cox proportional hazard analysis did not find differing surgical approaches to be an independent predictor of biochemical recurrence (hazard ratio, 0.53; 95% CI, 0.13-2.23; P=.39).

An SP transvesical RARP approach provides similar short-term oncologic control and surgical margin status as the gold-standard MP approach, and the 2 procedures share similar 1-year biochemical recurrence rates.