Clinical outcomes and postoperative costs of robot-assisted radical prostatectomy in patients with prostate cancer in South Korea: Nationwide cohort study

No national comparison has been conducted between robot-assisted radical prostatectomy (RARP) and other surgical techniques for prostate cancer in South Korea. This study aimed to assess the clinical outcomes and postoperative costs of RARP relative to other radical prostatectomy methods. We analyzed data from the National Health Insurance Service database for patients diagnosed with prostate cancer from 2004 to 2016. Patients who underwent RARP were matched with those who received other surgical treatments using propensity score matching. We then evaluated clinical outcomes and postoperative costs. Both groups comprised 12,108 patients, matched precisely by age, year of diagnosis, Charlson comorbidity index, hospital location, and hospital type. The RARP group experienced significantly lower transfusion rates (7.7 % vs. 39.2 %, p < 0.001), shorter hospital stays (8.96 days vs. 11.88 days, p < 0.001), and lower postoperative costs 1 year after surgery ($2775.40 vs. $2953.00, p = 0.004) compared to the non-RARP group. RARP was associated with better clinical outcomes and lower postoperative costs than other surgical methods, largely due to reduced complications and improved management of incontinence and ADT use. Although multivariate analysis did not show significant superiority, RARP may still present a cost-effective approach for prostate cancer treatment by enhancing clinical outcomes and decreasing healthcare costs.