br Corresponding author br Felix Preisser MD br

20 Corresponding author:
21 Felix Preisser, MD
22 Department of Urology, University Hospital Frankfurt, Frankfurt, Germany
24 email: [email protected]
29 Running head: Comparison of open and robotic CRP
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32 Disclosure of potential conflicts of interest:
33 The authors declare that they Ferrostatin-1 have no conflict of interest.
35 Research involving Human Participants and/or Animals:
38 Informed consent:
41 Authors’ Contribution statement:
42 F. Preisser: Protocol/project development, Data analysis, Manuscript writing/editing
43 S. Nazzani: Data analysis, Manuscript writing/editing
44 E. Mazzone: Manuscript writing/editing
45 M. Marchioni: Data collection or management
46 M. Bandini: Data analysis
47 Z. Tian: Data collection or management
48 A. Haese: Manuscript writing/editing
49 F. Saad: Manuscript writing/editing
50 K. C. Zorn: Data analysis, Manuscript writing/editing
51 F. Montorsi: Manuscript writing/editing
52 S. F. Shariat: Manuscript writing/editing
53 M. Graefen: Manuscript writing/editing
54 D. Tilki: Protocol/project development, Manuscript writing/editing
55 P. I. Karakiewicz: Protocol/project development, Data analysis, Manuscript writing/editing
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57 Microabstract
58 Cytoreductive radical prostatectomy (CRP) may offer a survival advantage, according to several
59 retrospective analyses. Within the National Inpatient Sample database, we tested intraoperative and
60 postoperative complications of robotically-assisted CRP relative to open CRP in metastatic prostate
61 cancer patients. The intraoperative and postoperative complications associated with robotically-
62 assisted CRP are lower than those of open CRP.
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63 Abstract
64 Purpose: Cytoreductive radical prostatectomy (CRP) may offer a survival advantage, according to
65 several retrospective analyses. However, no direct comparisons are available regarding the type of
66 surgical approach open vs. robotic in the metastatic setting. To address intraoperative and
67 postoperative complications of robotically-assisted CRP relative to open CRP in metastatic prostate
68 cancer patients.
69 Patients and Methods: Within the National Inpatient Sample database (2008-2013), we identified
70 metastatic prostate cancer patients Neutral substitution underwent robotically-assisted vs. open CRP. Multivariable
71 logistic regression (MLR), Poisson regression models (MPR) and linear regression models were
75 (p=0.5). In MLR models, robotically-assisted CRP resulted in lower rates of overall (Odds Ratio
80 recorded after adjustment for clustering.
81 Conclusion: The intraoperative and postoperative complications associated with robotically-
82 assisted CRP are lower than those of open CRP. Similarly, robotically-assisted CRP is associated
83 with shorter stay. Conversely, an increase in total hospital charges is associated with robotically-
84 assisted CRP. Nonetheless, robotically-assisted CRP complication profile validates its safety and
85 feasibility.
86 Key words: robotic-assisted; metastatic; National Inpatient Sample; complications; cytoreductive
87 prostatectomy
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89 Introduction
90 Cytoreductive radical prostatectomy (CRP) may result in a survival benefit relative to no
91 local therapy in patients with metastatic prostate cancer (mPCa), according to several retrospective
92 reports 1-8. Several previous investigators demonstrated lower perioperative complications, when
93 radical prostatectomy is performed with robotic-assistance, in clinically localized prostate cancer