SynthesisJournal of robotic surgery2025
Comparative effectiveness of robotic and laparoscopic radical prostatectomy: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials featuring geographic subgroup analyses.
Synthesis in Journal of robotic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- da VinciBMC surgery · 2026Pooled it
- Robotic versus laparoscopic radical prostatectomy: a large cohort study using the 24-hour pad test highlights the impact of continence definition on functional outcomes.Journal of robotic surgery · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Robot-assisted radical prostatectomy (RARP) has rapidly supplanted conventional laparoscopic radical prostatectomy (LRP), despite the limited high-quality comparative evidence. This systematic review synthesizes randomized controlled trial data comparing RARP with LRP for localized prostate cancer, incorporating the GRADE certainty assessment and pre-planned geographic subgroup analyses. This systematic review and meta-analysis was prospectively registered in PROSPERO (CRD420251207193). We conducted a PRISMA-compliant systematic review of MEDLINE, Embase, Cochrane CENTRAL, Scopus, Web of Science, and ClinicalTrials.gov through October 2025 for randomized controlled trials comparing RARP with LRP (2D/3D) in men with localized or locally advanced prostate cancer. The primary outcomes were 12-month urinary continence and erectile function scores. Secondary outcomes included perioperative metrics, complications, and positive surgical margins. Random-effects meta-analyses estimated risk ratios (RR) and mean differences (MD) with 95% confidence intervals. The risk of bias was assessed using the Cochrane RoB 2 tool, and the certainty of evidence was evaluated using the GRADE methodology. Four randomized controlled trials (1095 participants) met the inclusion criteria, with 734 patients in the RARP group and 361 patients in the LRP group. Conventional LRP achieved significantly superior 12-month urinary continence compared to RARP (RR 1.12, 95% CI 1.03-1.22; p = 0.006; I²=0%; moderate-certainty evidence), equivalent to 66 additional continent patients per 1,000 treated. Erectile function recovery at 12 months significantly favored LRP (RR 1.39, 95% CI 1.09-1.76; p = 0.007; I²=0%; moderate-certainty evidence), representing 91 additional potent patients per 1,000 patients. Positive surgical margins did not differ significantly (RR 1.11, 95% CI 0.85-1.44; p = 0.45; low-certainty evidence), supporting equivalent oncological safety. Perioperative outcomes, including operative time (MD 4.18 min, 95% CI - 0.51 to 8.87; p = 0.08), estimated blood loss (MD - 26.24 mL, 95% CI - 98.68 to 46.21; p = 0.48; I²=91%), and overall complications (RR 0.94, 95% CI 0.52-1.68; p = 0.83) showed no significant differences. The geographic subgroup analysis suggested potential regional variation, but the tests for interaction were not significant. This randomized evidence synthesis demonstrates that conventional laparoscopic radical prostatectomy was associated with significantly better urinary continence and erectile function at 12 months compared with robot-assisted approaches, while maintaining comparable oncologic and perioperative outcomes. These findings suggest that surgeon expertise and institutional experience may be important determinants of patient outcomes, independent of the technology platform employed.
Indexed as
Identifiers
41345763What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.