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Robotic Surgery
Treatment Comparison

Comparing surgery and radiation for prostate cancer

The following table compares outcomes following prostate cancer treatment – specifically, surgery (radical prostatectomy), which is considered the gold standard treatment for localized prostate cancer – and radiation (brachytherapy and external beam radiation). Data is provided on survival, cancer recurrence, incidence of rectal and bladder cancer, bowel function, urinary bladder and long-term erectile function. In this table, radical prostatectomy includes all approaches to prostate surgery (open surgery through large incisions; conventional minimally invasive, or laparoscopic radical prostatectomy – also called LRP – as well as da Vinci Prostatectomy, or dVP). As you can see, surgery offers measurable advantages over radiation in terms of outcomes and survivability.

Chart 1: Outcome Comparison: Surgery vs. Radiotherapy
Outcome
Radical Prostatectomy*
Radiation**
Survival duration compared to conservative disease management1
8.6 years
4.6 years
15-year prostate cancer survival rate2
92%
87%
Survival rate for high-grade cancer patients3
45% increase in overall survival rate vs. radiotherapy
 -
Risk of cancer-specific death for
high-grade cancer patients4
49% less risk vs. radiotherapy
 -
Cancer recurrence5
Easy to detect
Difficult to detect
Risk of rectal cancer
(Within 10 year follow-up) 6
5.1 out of 1000
10.0 out of 1000
Risk of bladder cancer7
0.8% developed bladder cancer
1.3% developed bladder cancer
Bowel function impairment8
-
Significantly greater vs. surgery
Disease-specific long-term quality of life9
Stable
Unstable
Painful urination (at 18 month follow-up) 10
1% of patients
30% of patients
Long-term erectile dysfunction11
Lower risk
Higher risk

*Open surgery; comparable long-term data not yet available on da Vinci® Prostatectomy.
**External Beam Radiation Therapy (EBRT) unless otherwise noted in the citation.