RRP v. "robot assisted" RP: Margins

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Steve Jordan - 26 Nov 2007 20:31 GMT

"In the hands of surgeons experienced in robotic assisted laparoscopic
radical prostatectomy and radical retropubic prostatectomy, there was a
statistically significant lower positive margin rate for patients
undergoing robotic assisted laparoscopic radical prostatectomy."

See http://www.jurology.com/article/PIIS0022534707019799/abstract

Regards,

Steve J

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ron - 26 Nov 2007 20:57 GMT

> "In the hands of surgeons experienced in robotic assisted laparoscopic
> radical prostatectomy and radical retropubic prostatectomy, there was a
[quoted text clipped - 6 lines]
>
> Steve J

Steve...Do you have access to the editorial comments that accompanied
this article?..ron

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Steve Jordan - 26 Nov 2007 22:43 GMT

On November 26, ron inquired:

> Steve...Do you have access to the editorial comments that accompanied
> this article?

'Fraid not. I'm not a subscriber to J Urol, so must pay $30 per article
for certain "restricted" items. Among them, correspondence and editorials.

I just get the free stuff.

Your friendly local uro might have a copy, though. Or a hospital
library, free or just for the price of copying.

Regards,

Steve J

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I.P. Freely - 26 Nov 2007 23:20 GMT

> On November 26, ron inquired:
>
[quoted text clipped - 8 lines]
> Your friendly local uro might have a copy, though. Or a hospital
> library, free or just for the price of copying.

My VA hospital gives patients open access to their medical library,
including hardcopy, electronic file, and online resources. Maybe some
other hospital libraries do the same ... or don't have locks on the door.

I.P.

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I.P. Freely - 26 Nov 2007 21:37 GMT

> "In the hands of surgeons experienced in robotic assisted laparoscopic
> radical prostatectomy and radical retropubic prostatectomy, there was a
> statistically significant lower positive margin rate for patients
> undergoing robotic assisted laparoscopic radical prostatectomy."
>
> See http://www.jurology.com/article/PIIS0022534707019799/abstract

\
However, from the same abstract, the rob-lap pts had more favorable
tumor characteristics, including lower PSA, lower clinical stage, lower
Gleason score, and lower ratio of tumor volume to prostate volume. They
should have INHERENTLY fewer positive margins. With over 1,700 pts to
choose from, couldn't they have picked more similar cohorts without
digging too far back in the rob-lap learning curve?

I.P.

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David&Joan - 27 Nov 2007 04:05 GMT

Isn't this just cherry picking your patient base and has no statistical
merit?

David

> "In the hands of surgeons experienced in robotic assisted laparoscopic
> radical prostatectomy and radical retropubic prostatectomy, there was a
[quoted text clipped - 6 lines]
>
> Steve J

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Steve Jordan - 27 Nov 2007 04:37 GMT

On November 26, David&Joan inquired:

> Isn't this just cherry picking your patient base and has no statistical
> merit?

Beats me.

I'm just the messenger.

Regards,

Steve J

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