Prostatectomy Treatment Comparison

Surgery vs. Radiation

While long-term data is not yet available comparing da Vinci® Surgery to radiation, there are large studies that compare surgery to radiation. These studies found that surgery to remove the prostate (known as radical prostatectomy) offers patients a better chance of survival compared to radiation.

The table below compares results after open surgery with radiation or radiotherapy (brachytherapy and external beam radiation). Data is provided on: survival, cancer returning, rates of rectal and bladder cancer, bowel function, urinary issues and long-term (sexual) erectile function. Surgery is considered the gold standard treatment for localized prostate cancer because of its benefits over radiation.

In this table, radical prostatectomy includes all types of surgery: open surgery through a large incision, manual laparoscopic surgery, as well as da Vinci robotic-assisted surgery.

Outcome Comparison: Surgery vs. Radiation

Outcome	Radical Prostatectomy	Radiation*
Survival duration compared to conservative disease management¹	8.6 years	4.6 years
15-year prostate cancer survival rate¹	92%	87%
Survival rate for high-grade cancer patients²	44% increase in overall survival rate vs. radiotherapy	-
Risk of cancer-specific death for high-grade cancer patients²	49% less risk vs. radiotherapy	-
Bowel function impairment³	-	Significantly greater vs. surgery
Disease-specific long-term quality of life⁴	Stable	Unstable
Painful urination (at 24 month follow-up)⁵	2.1% of patients	19% of patients

*External Beam Radiation Therapy (EBRT) unless otherwise noted in the citation.

Long-Term Survival for Localized Prostate Cancer

With any cancer treatment, the first priority is survival. A recent study suggests there is a greater chance of long-term survival for patients undergoing surgery when compared to other treatments.⁶

In this large study of patients receiving treatment for prostate cancer, those receiving radiation (including IMRT) and hormone therapy were two and three times more likely to die, respectively, than radical prostatectomy (surgery) patients.⁶ In fact, surgery patients who had their cancerous prostate removed had the lowest cancer death rate.⁶

In a previous study that included watching waiting, the patients who had a radical prostatectomy had a higher prostate cancer survival rate than men choosing other treatments.⁷

Graph of Prostate Cancer Survival is better with Surgery

The da Vinci Surgical System is a state-of-the-art surgical platform with 3D, high-definition vision and miniaturized, wristed surgical instruments designed to help doctors take surgery beyond the limits of the human hand. Though it is often called a “robot,” da Vinci cannot act on its own - surgery is performed entirely by your doctor from start to finish. By overcoming the limitations of traditional open and laparoscopic surgery, da Vinci is changing the experience of surgery for people around the world.

If you have been told you need treatment for prostate cancer, it's time to ask your doctor about da Vinci Surgery.

By overcoming the limitations of traditional open and laparoscopic surgery, da Vinci is changing the experience of surgery for people around the world. If you have been told you need treatment for prostate cancer, it's time to ask your doctor about da Vinci Surgery.

To find a da Vinci surgeon near you, go to our Surgeon Locator

Discover:

Learn why da Vinci Surgery may be your best treatment option for prostate cancer.

Tewari A, Raman JD, Chang P, Rao S, Divine G, Menon M. Long-term survival probability in men with clinically localized prostate cancer treated either conservatively or with definitive treatment (radiotherapy or radical prostatectomy). Urology. 2006 Dec;68(6):1268-74
Tewari A, Divine G, Chang P, Shemtov MM, Milowsky M, Nanus D, Menon M. Long-term survival in men with high grade prostate cancer: a comparison between conservative treatment, radiation therapy and radical prostatectomy--a propensity scoring approach. J Urol. 2007 Mar;177(3):911-5. Erratum in: J Urol. 2007 May;177(5):1958
Litwin MS, Sadetsky N, Pasta DJ, Lubeck DP. Bowel function and bother after treatment for early stage prostate cancer: a longitudinal quality of life analysis from CaPSURE. J Urol. 2004 Aug;172(2):515-9.
Miller DC, Sanda MG, Dunn RL, Montie JE, Pimentel H, Sandler HM, McLaughlin WP, Wei JT. Long-term outcomes among localized prostate cancer survivors: health-related quality-of-life changes after radical prostatectomy, external radiation, and brachytherapy.J Clin Oncol. 2005 Apr 20;23(12):2772-80.
Buron C, Le Vu B, Cosset JM, Pommier P, Peiffert D, Delannes M, Flam T, Guerif S, Salem N, Chauveinc L, Livartowski A. Brachytherapy versus prostatectomy in localized prostate cancer: results of a French multicenter prospective medico-economic study. Int J Radiat Oncol Biol Phys.2007 Mar 1;67(3):812-22.
Cooperberg MR, Vickers AJ, Broering JM, Carroll PR. Comparative risk-adjusted mortality outcomes after primary surgery, radiotherapy, or androgen-deprivation therapy for localized prostate cancer. Cancer. 2010 Nov 15;116(22):5226-34. doi: 10.1002/cncr.25456
Merglen A, Schmidlin F, Fioretta G, Verkooijen HM, Rapiti E, Zanetti R, Miralbell R, Bouchardy C. Short- and long-term mortality with localized prostate cancer. Arch Intern Med. 2007 Oct 8;167(18):1944-50.

While clinical studies support the effectiveness of the da Vinci Surgical System when used in minimally invasive surgery, individual results may vary. There are no guarantees of outcome. All surgeries involve the risk of major complications. Before you decide on surgery, discuss treatment options with your doctor. Understanding the risks of each treatment can help you make the best decision for your individual situation. Surgery with the da Vinci Surgical System may not be appropriate for every individual; it may not be applicable to your condition. Always ask your doctor about all treatment options, as well as their risks and benefits. Only your doctor can determine whether da Vinci Surgery is appropriate for your situation. The clinical information and opinions, including any inaccuracies expressed in this material by patients or doctor about da Vinci Surgery are not necessarily those of Intuitive Surgical, Inc. and should not be considered as substitute for medical advice provided by your doctor. All people depicted unless otherwise noted are models. © 2012 Intuitive Surgical. All rights reserved. Intuitive, Intuitive Surgical, da Vinci, da Vinci S, da Vinci Si, Single-Site, InSite, TilePro and EndoWrist are trademarks or registered trademarks of Intuitive Surgical. All other product names are trademarks or registered trademarks of their respective holders.

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