Evidence map›Paper›PMID 42230439›Full record

ReviewInternational urology and nephrology2026

Comparative functional, perioperative and oncological outcomes of robot-assisted and open radical prostatectomy: a systematic review and meta-analysis.

Caio Vinicius Suartz, Mateus Silva Santos Costa, Caio Felipe Araujo Matalani, Marcelo Ribeiro da Rocha, José Pedro Cassemiro Micheleto, Pedro Luis Furlam, Henrique Laurent Lepine, Roberto Iglesias Lopes, Thalita Bento Talizin, José Bessa Júnior and 11 more

Abstract readReview
PubMed Publisher
In one paragraph

Review in International urology and nephrology, 2026. 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.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Caio Vinicius SuartzUrology Department, Northern Ontario School of Medicine, 955, Oliver Road, Thunder Bay, ON, Canada. caio.v_suartz@hotmail.com.
Mateus Silva Santos CostaDivision of Urology, Institute of Cancer of São Paulo, University of São Paulo, São Paulo, Brazil.
Caio Felipe Araujo MatalaniDivision of Urology, Institute of Cancer of São Paulo, University of São Paulo, São Paulo, Brazil.
Marcelo Ribeiro da RochaDivision of Urology, Institute of Cancer of São Paulo, University of São Paulo, São Paulo, Brazil.
José Pedro Cassemiro MicheletoDivision of Urology, Institute of Cancer of São Paulo, University of São Paulo, São Paulo, Brazil.
Pedro Luis FurlamDivision of Urology, Institute of Cancer of São Paulo, University of São Paulo, São Paulo, Brazil.
Henrique Laurent LepineDivision of Urology, Institute of Cancer of São Paulo, University of São Paulo, São Paulo, Brazil.
Roberto Iglesias LopesDivision of Urology, Institute of Cancer of São Paulo, University of São Paulo, São Paulo, Brazil.
Thalita Bento TalizinDivision of Urology, Institute of Cancer of São Paulo, University of São Paulo, São Paulo, Brazil.
José Bessa JúniorDepartment of Health, State University of Feira de Santana (UEFS), Feira de Santana, BA, Brazil.
Walid ShahrourUrology Department, Northern Ontario School of Medicine, 955, Oliver Road, Thunder Bay, ON, Canada.
Walid ShabanaUrology Department, Northern Ontario School of Medicine, 955, Oliver Road, Thunder Bay, ON, Canada.
Axel S MerseburgerDepartment of Urology, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany.
Leonardo Oliveira ReisUroScience, School of Medical Sciences, State University of Campinas, Unicamp, and ImmunOncology, Pontifical Catholic University of Campinas, PUC-Campinas, Campinas, SP, 13083-872, Brazil.
Maurício Dener CordeiroDivision of Urology, Institute of Cancer of São Paulo, University of São Paulo, São Paulo, Brazil.
William Carlos NahasDivision of Urology, Institute of Cancer of São Paulo, University of São Paulo, São Paulo, Brazil.
Paul TorenCHU de Québec-Université Laval, Quebec City, QC, Canada.
Leopoldo Alves Ribeiro-FilhoDivision of Urology, Institute of Cancer of São Paulo, University of São Paulo, São Paulo, Brazil.
Guillaume PloussardDepartment of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France.
Vincent FradetCHU de Québec-Université Laval, Quebec City, QC, Canada.
Frédéric PouliotCHU de Québec-Université Laval, Quebec City, QC, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRobot-assisted radical prostatectomy (RARP) has increasingly replaced open radical prostatectomy (ORP) based on evidence suggesting improved perioperative outcomes and faster recovery. However, few randomized trials directly compare both techniques. This review compares perioperative, functional, and oncological outcomes of RARP versus ORP, integrating newly available high-impact studies.

methodsA thorough search of major databases was conducted from the inception of each database up to November 2025, adhering to PRISMA guidelines. Two reviewers independently screened studies in a three-step process-titles, abstracts, and full texts. Only randomized controlled trials (RCTs) and prospective studies comparing RARP and ORP were included. All variables were entered into a spreadsheet for analysis and cross-checked. The primary endpoints assessed were perioperative complications, functional recovery (urinary continence and erectile function), and oncological outcomes.

resultsA total of 27 studies comprising 38,530 patients were included. Compared with ORP, RARP was associated with significantly reduced intraoperative blood loss (mean difference [MD] :  - 576.78; p < 0.01), lower transfusion rates (Odds Ratio [OR] 0.27; p < 0.0001), and shorter hospital stay (MD:   - 1.44 days; p < 0.0001). RARP also demonstrated fewer postoperative complications (OR 0.59; p = 0.002). Regarding functional outcomes, RARP yielded superior urinary continence recovery at 3 months and improved erectile function recovery (OR 1.43). Additionally, RARP showed a lower biochemical recurrence rate at 24 months (OR 1.34), with no significant difference observed in short-term follow-up (< 12 months).

conclusionRARP offers advantages over ORP, particularly in reducing perioperative morbidity and enhancing functional recovery while maintaining comparable or superior oncological outcomes. However, further randomized controlled trials with extended follow-up are necessary to confirm these findings. KEY MESSAGES: 1. RARP was associated with significantly reduced blood loss, lower transfusion requirements, and shorter hospitalization. 2. Functional outcomes favored RARP, including superior recovery of urinary continence and higher rates of nerve-sparing preservation. 3. Overall, the evidence supports RARP as a safe, effective, and clinically advantageous approach for localized prostate cancer.

Indexed as

Functional outcomesMeta-analysisOncological outcomesOpen radical prostatectomyPerioperative outcomesProstate cancerRandomized controlled trialRobot-assisted radical prostatectomy

Identifiers

PMID42230439

What OpenQuestion holds

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Registered trials

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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.