OBJECTIVES:Survivors of Prostate Cancer (PCa) suffer work productivity loss in the form of missed workdays and employment disability. Robotic-Assisted Laparoscopic Prostatectomy (RALP) has become the most common approach for surgical treatment of localized prostate cancer despite its higher costs. RALP is known to reduce length of hospital stay and postoperative complications which allows earlier convalescence that may reduce the time needed to return to work after treatment. This meta-analysis aims to summarize the current evidence on the impact of RALP on time to return to work (RTW) after surgery in comparison with open retropubic prostatectomy (ORP).

METHODS:Two databases (PubMed and EMBASE) were searched using OVID SP platform to identify comparative studies of RALP and ORP that reported time to return to work after surgery for patients with localized prostate cancer from 1/1/2000-8/6/2019. A Random-effects model will be used to pool the mean difference in time to RTW. Heterogeneity parameters will be reported including Cochran Q and Higgin’s & Thompson’s I² statistics. Publication bias will be evaluated using a funnel plot.

RESULTS: Our search retrieved 631 papers. Eight non-randomized studies from 5 countries were included in the qualitative analysis. Five studies of 8832 patients (RALP = 4734, RRP = 4098) were eligible for inclusion in the meta-analysis. The pooled estimate of difference in time to return to work estimated by Random-Effects model was 6.42 days (95%CI: 5.11, 7.73). No statistical heterogeneity was detected with I² = 0. Publication bias is not suspected as funnel plot showed no asymmetry.

CONCLUSIONS: Robotic assisted prostatectomy reduces the time needed to return to work by 6.4 days. Our analysis is limited by the number of available studies and their non-randomized design. There is a need for large prospective study to address the impact of RALP on time to RTW in the United States.