Close, Andrew

Fraser, Cynthia

Gurung, Tara

Jia, Xueli

Pickard, Robert

Ramsay, Craig

Robertson, Clare

Sharma, Pawana

Vale, Luke

BJU International

English

Research Archive

1636–47 Systematic review and comparative meta-analysis of outcomes from robotic and laparoscopic prostatatectomy ©

A comparison of laparoscopic and robotic assisted suturing performance by experts and novices.

Bayesian methods in meta-analysis and evidence synthesis. Stat Methods Med Res

Biochemical recurrence after robot-assisted radical prostatectomy in a European single-centre cohort with a minimum follow-up time of 5 years. Eur Urol

Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Prostate Cancer.V.3.2011.

Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [document on the Internet]. The Cochrane Collaboration, 2011.Available at: http://www.cochrane-handbook.org/. Accessed

Combination of direct and indirect evidence in mixed treatment comparisons. Stat Med

Comprehensive standardized report of complications of retropubic and laparoscopic radical prostatectomy. Eur Urol

Conducting indirect-treatment-comparison and network-meta-analysis studies: report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: part 2. Value Health

costs and comparative eﬀectiveness of robotic assisted, laparoscopic and open urological surgery.

Costs of radical prostatectomy for prostate cancer: a systematic review.

Do the ﬁndings of case series studies vary signiﬁcantly according to methodological characteristics? Health Technol Assess

Evaluating non-randomised intervention studies. Health Technol Assess

Evidence from robot-assisted laparoscopic radical prostatectomy: a systematic review. Eur Urol

First 500 cases of robotic-assisted laparoscopic radical prostatectomy from a single UK centre: learning curves of two surgeons.

Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev

for Health and Clinical Excellence. Improving Outcomes in Urological Cancers – Manual. London: National Insititute for Health and Clinical Excellence,

Health Technology Assessment of Robot-Assisted Surgery in Selected Surgical Procedures. Dublin: Health Information and Quality Authority Health Technology Assessment Directorate,

Indirect comparisons of competing interventions. Health Technol Assess

International Society of Urological Pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens: rationale and organization. Mod Pathol

Interpreting indirect treatment comparisons and network meta-analysis for health-care decision making: report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: part 1. Value Health

Issues relating to study design and risk of bias when including non-randomized studies in systematic reviews on the eﬀects of interventions. Res Synth Methods

Laparoscopic radical prostatectomy with a remote controlled robot.

Laparoscopic radical prostatectomy: technical and early oncological assessment of 40 operations. Eur Urol

Laparoscopic versus open radical retropubic prostatectomy: a case-control study at a single institution. Arch Ital Urol Androl

Outcomes of retropubic, laparoscopic, and robotic-assisted prostatectomy. Urology

Positive surgical margin and perioperative complication rates of primary surgical treatments for prostate cancer: a systematic review and meta-analysis comparing retropubic, laparoscopic, and robotic prostatectomy. Eur Urol

Positive surgical margins in radical prostatectomy: outlining the problem and its long-term consequences. Eur Urol

Randomized comparison between laparoscopic and robot-assisted nerve-sparing radical prostatectomy.

Robot-Assisted Surgery Compared with Open Surgery and Laparoscopic Surgery: Clinical Eﬀectiveness and Economic Analyses.

Surgical research or comic opera: questions, but few answers. Lancet

Systematic review and economic modelling of the relative clinical beneﬁt and cost-eﬀectiveness of laparoscopic surgery and robotic surgery for removal of the prostate in men with localised prostate cancer. Health Technol Assess

Systematic review and meta-analysis of perioperative outcomes and complications after robot-assisted radical prostatectomy. Eur Urol

Systematic review and meta-analysis of studies reporting oncologic outcome after robot-assisted radical prostatectomy. Eur Urol

Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol

The role of laparoscopic radical prostatectomy in the era of robotic surgery. Eur Urol Suppl

Transatlantic Consensus Group on active surveillance and focal therapy for prostate cancer.

UK Department of Health,

Use of indirect and mixed treatment comparisons for technology assessment. Pharmacoeconomics

Variations among experienced surgeons in cancer control after open radical prostatectomy.

WINBUGS: a Bayesian modelling framework: concepts, structure and extensibility.

Relative effectiveness of robot-assisted and standard laparoscopic prostatectomy as alternatives to open radical prostatectomy for treatment of localised prostate cancer : a systematic review and mixed treatment comparison meta-analysis

Objective:

To compare the effectiveness of robot-assisted and standard laparoscopic prostatectomy.

Methods:

A care pathway was described. We performed a systematic literature review based on a search of Medline, Medline in Process, Embase, Biosis, Science Citation Index, Cochrane Controlled Trials Register, Current Controlled Trials, Clinical Trials, WHO International Clinical Trials Registry and NIH Reporter, the Health Technology Assessment databases, the Database of Abstracts of Reviews of Effects, and relevant conference abstracts up to 31st October 2010). Additionally, reference lists were scanned, an expert panel consulted, and websites of manufacturers, professional organisations, and regulatory bodies were checked. We selected randomised controlled trials (RCTs) and non-randomised comparative studies, published after 1st January 1995, including men with localised prostate cancer undergoing robot-assisted or laparoscopic prostatectomy compared with the other procedure or with open prostatectomy. Studies where at least 90% of included men had clinical tumour stages T1 to T2 and which reported at least one of our specified outcomes were eligible for inclusion. A mixed-treatment comparison meta-analysis was performed to generate comparative statistics on specified outcomes.

Results:

We included data from 19 064 men across one RCT and 57 non-randomised comparative reports. Robotic prostatectomy had a lower risk of major intra-operative harms such as organ injury [0.4% robotic vs 2.9% laparoscopic], odds ratio ([OR] {95% credible interval [CrI]} 0.16 [0.03 to 0.76]), and a lower rate of surgical margins positive for cancer [17.6% robotic vs 23.6% laparoscopic], OR [95% CrI] 0.69 [0.51 to 0.96]). There was no evidence of a difference in the proportion of men with urinary incontinence at 12 months (OR [95% CrI] 0.55 [0.09 to 2.84]). There were insufficient data on sexual dysfunction. Surgeon learning rates for the procedures did not differ, although data were limited.

Conclusions:

Men undergoing robotic prostatectomy appear to have reduced surgical morbidity, and a lower risk of a positive surgical margin, which may reduce rates of cancer recurrence and the need for further treatment, but considerable uncertainty surrounds these results. We found no evidence that men undergoing robotic prostatectomy are disadvantaged in terms of early outcomes. We were unable to determine longer-term relative effectiveness

Relative effectiveness of robot-assisted and standard laparoscopic prostatectomy as alternatives to open radical prostatectomy for treatment of localised prostate cancer : a systematic review and mixed treatment comparison meta-analysis

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