{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T08:19:54Z","timestamp":1788164394664,"version":"build-2803163510"},"reference-count":35,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SJU"],"abstract":"<jats:p>Objective: To compare surgical complications, biochemical failure, and mortality rates between open radical prostatectomy (ORP) and robot-assisted radical prostatectomy (RARP).\nMaterial and methods: All men undergoing radical prostatectomy (1995\u20132023) at a single academic hospital were included, and preoperative factors, surgical parameters, complications, biochemical failures, and mortality were collected. Generalized linear models and cause-specific Cox regressions stratified by surgical procedure were used. Cumulative incidences of biochemical failure were estimated with the Aalen-Johansen estimator, accounting for death as a competing risk. Analyses of surgical complications were adjusted for age and lymphadenectomy, while positive surgical margins, biochemical failure, and mortality were adjusted for preoperative PSA, pathological lymph node stage, pT category, tumor percentage, ISUP score, age, and year of surgery.\nResults: A total of 3,477 men were included (ORP: 1,759; RARP: 1,718). RARP was associated with reduced odds of in-hospital complications (adjusted odds ratio [aOR]: 0.28, 95% confidence interval [CI]: 0.11\u20130.74). RARP was associated with a reduced risk of biochemical failure compared to ORP (unadjusted hazard ratio [HR]: 0.52, 95% CI: 0.29\u20130.93). No other outcomes or mortality rates differed significantly. \nConclusion: RARP was superior in terms of complications and non-inferior for oncological outcomes compared to ORP at our center. Although the only randomized trial yet, has not proven any significant improvement in long-term cancer control comparing the open versus robotic approach, RARP seems to have replaced ORP as the gold standard for surgical treatment of localized prostate cancer. However, the overall benefit of RARP in the surgical evolution remains elusive.<\/jats:p>","DOI":"10.2340\/sju.v61.46750","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T08:11:21Z","timestamp":1788163881000},"page":"202-209","source":"Crossref","is-referenced-by-count":0,"title":["Comparative analysis of surgical outcomes: open versus robot-assisted radical prostatectomy"],"prefix":"10.2340","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9587-4119","authenticated-orcid":false,"given":"Rikke Groth","family":"Olsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6562-6416","authenticated-orcid":false,"given":"Klaus","family":"Brasso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0019-5333","authenticated-orcid":false,"given":"Andreas","family":"R\u00f8der","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1258-5822","authenticated-orcid":false,"given":"Lars","family":"Konge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8617-7453","authenticated-orcid":false,"given":"Flemming","family":"Bjerrum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7293-9506","authenticated-orcid":false,"given":"Hein Vincent","family":"Stroomberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"166728","doi-asserted-by":"crossref","unstructured":"Chandrasekar T, Tilki D. Robotic-assisted vs. open radical prostatectomy: an update to the never-ending debate. Transl Androl Urol. 2018;7(Suppl 1):S120\u2013S123.","DOI":"10.21037\/tau.2017.12.20"},{"key":"166729","doi-asserted-by":"crossref","unstructured":"Howard JM. Robotic, laparoscopic, and open radical prostatectomy \u2013 is the jury still out? JAMA Netwo Open. 2021;4:9.","DOI":"10.1001\/jamanetworkopen.2021.20693"},{"key":"166730","doi-asserted-by":"crossref","unstructured":"Yaxley JW, Coughlin GD, Chambers SK, et al. Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study. Lancet. 2016;388(10049):1057\u20131066.","DOI":"10.1016\/S0140-6736(16)30592-X"},{"key":"166731","doi-asserted-by":"crossref","unstructured":"\u00c7olako\u011flu Y, Ek\u015fi M, \u00d6zl\u00fc DN, et al. Comparison of oncological and functional results of robotic and open perineal radical prostatectomy. Int J Urol. 2024;31(9):994\u20131000.","DOI":"10.1111\/iju.15500"},{"key":"166732","doi-asserted-by":"crossref","unstructured":"Carlsson S, Nilsson AE, Schumacher MC, et al. Surgery-related Complications in 1253 Robot-assisted and 485 Open Retropubic Radical Prostatectomies at the Karolinska University Hospital, Sweden. Urology. 2010;75(5):1092\u20131097.","DOI":"10.1016\/j.urology.2009.09.075"},{"key":"166733","doi-asserted-by":"crossref","unstructured":"Nahas WC, Rodrigues GJ, Rodrigues Gon\u00e7alves FA, et al. Perioperative, oncological, and functional outcomes between robot-assisted laparoscopic prostatectomy and open radical retropubic prostatectomy: a randomized clinical trial. J Urol. 2024;212(1):32\u201340.","DOI":"10.1097\/JU.0000000000003967"},{"key":"166734","doi-asserted-by":"crossref","unstructured":"Baboudjian M, Grabia A, Barret E, et al. Real-life perioperative outcomes of radical prostatectomy using the french national registry: a plea for promotion of centralized care and access to minimally invasive approaches. Eur Urol Oncol. 2024;7(3):316\u2013318.","DOI":"10.1016\/j.euo.2023.10.006"},{"key":"166735","doi-asserted-by":"crossref","unstructured":"Ambrosini F, Knipper S, Tilki D, et al. Robot-assisted vs open retropubic radical prostatectomy: a propensity score-matched comparative analysis based on 15 years and 18,805 patients. World J Urol. 2024;42(1):1\u20137.","DOI":"10.1007\/s00345-024-04824-6"},{"key":"166736","doi-asserted-by":"crossref","unstructured":"Simsir A, Kizilay F, Aliyev B, et al. Comparison of robotic and open radical prostatectomy: initial experience of a single surgeon. Pak J Med Sci. 2021;37(1):167.","DOI":"10.12669\/pjms.37.1.2719"},{"key":"166737","doi-asserted-by":"crossref","unstructured":"Haese A, Knipper S, Isbarn H, et al. A comparative study of robot-assisted and open radical prostatectomy in 10 790 men treated by highly trained surgeons for both procedures. BJU Int. 2019;123(6):1031\u20131040.","DOI":"10.1111\/bju.14760"},{"key":"166738","doi-asserted-by":"crossref","unstructured":"D\u2019Amico AV, Whittington R, Bruce Malkowicz S, et al. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. J Am Med Assoc. 1998;280(11):969\u2013974.","DOI":"10.1001\/jama.280.11.969"},{"key":"166739","doi-asserted-by":"crossref","unstructured":"Van Leenders GJLH, Van Der Kwast TH, Grignon DJ, et al. The 2019 International Society of Urological Pathology (ISUP) consensus conference on grading of prostatic carcinoma. Am J Surg Pathol. 2020;44(8):e87.","DOI":"10.1097\/PAS.0000000000001497"},{"key":"166740","doi-asserted-by":"crossref","unstructured":"Epstein JI, Allsbrook WC, Amin MB, et al. The 2005 International Society of Urological Pathology (ISUP) consensus conference on Gleason grading of prostatic carcinoma. Am J Surg Pathol. 2005;29(9):1228\u20131242.","DOI":"10.1097\/01.pas.0000173646.99337.b1"},{"key":"166741","doi-asserted-by":"crossref","unstructured":"Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205\u2013213.","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"166742","doi-asserted-by":"crossref","unstructured":"StroombergHV, Larsen SB, Lanth\u00e9n GS, et al. Danish Prostate Registry (DanProst) \u2013 an updated version of the Danish Prostate Cancer Registry, methodology, and early results. J Med Syst. 2023;47(1):98.","DOI":"10.1007\/s10916-023-01991-8"},{"key":"166743","doi-asserted-by":"crossref","unstructured":"Martin AD, Nunez RN, Andrews JR, et al. 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Scand J Urol. 2026;61:1\u20136.","DOI":"10.2340\/sju.v61.45236"},{"key":"166750","doi-asserted-by":"crossref","unstructured":"Lantz A, Bock D, Akre O, et al. Functional and oncological outcomes after open versus robot-assisted laparoscopic radical prostatectomy for localised prostate cancer: 8-year follow-up. Eur Urol. 2021;80(5):650\u2013660.","DOI":"10.1016\/j.eururo.2021.07.025"},{"key":"166751","doi-asserted-by":"crossref","unstructured":"Du Y, Long Q, Guan B, et al. Robot-assisted radical prostatectomy is more beneficial for prostate cancer patients: a system review and meta-analysis. Med Sci Monit. 2018;24:272\u2013287.","DOI":"10.12659\/MSM.907092"},{"key":"166752","doi-asserted-by":"crossref","unstructured":"Orrason AW, Scilipoti P, Garmo H, et al. Improved adherence to prostate cancer guidelines concomitant with public reporting. Nationwide population-based study. 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