Robot-assisted radical prostatectomy for high-risk and locally advanced prostate cancer: a bibliometric and evidence-mapping analysis of oncologic safety, functional outcomes, lymph-node management, and multimodal treatment

Pelvic lymph node dissection during robot-assisted radical prostatectomy: a bibliometric analysis of surgical extent, nodal staging, and lymphatic morbidity

Global research trends in pelvic lymph node dissection during robot-assisted radical prostatectomy: a bibliometric and knowledge-mapping analysis

Radiotherapy integration after transoral robotic surgery in head and neck cancer: a bibliometric and knowledge-mapping analysis of adjuvant treatment, de-escalation, functional preservation, and survival outcomes

Transoral robotic surgery (TORS) is increasingly considered within multimodality treatment pathways for selected head and neck cancers, in which postoperative pathology may influence radiotherapy (RT), chemoradiotherapy (CRT), treatment de-intensification, and functional preservation. This study characterized the development, knowledge structure, and thematic evolution of research on RT integration after TORS. Publications from 1 January 2010 to 1 August 2026 were retrieved from the Web of Science Core Collection, Scopus, and PubMed. After deduplication, exclusion of records lacking predefined fields required for downstream analyses, and manual topical screening, 215 publications were included. Bibliometric and knowledge-mapping analyses assessed publication and citation trends, contributors and collaboration, co-citation, bibliographic coupling, keyword and thematic evolution, and exploratory logistic life-cycle and latent Dirichlet allocation (LDA) models. The 215 publications were distributed across 54 sources, with an annual growth rate of 14.72%; 60.0% were published during 2020–2026. International co-authorship accounted for 13.49%. The United States was the leading corresponding-author country, accounting for 96 publications (44.7% of the total corpus). Citation and co-citation structures linked foundational TORS studies with evidence on HPV-associated prognosis and postoperative RT/CRT. Keyword and thematic analyses showed persistent prominence of TORS and oropharyngeal squamous cell carcinoma, alongside increasing representation of adjuvant treatment, HPV-associated disease, swallowing, and functional outcomes. Bibliographic coupling and factorial analysis indicated substantial thematic overlap rather than clearly separated research domains. Exploratory logistic modeling showed only moderate fit (R² = 0.778) and did not fully capture the empirical publication peak, while the five-topic LDA solution had limited bootstrap stability (0.3356). The literature has shifted from predominantly procedure-centered investigation toward greater attention to risk-adapted postoperative management. Current research increasingly integrates treatment selection, RT dose and target-volume modification, and functional outcomes. Prospective multicenter studies with standardized postoperative risk definitions and long-term oncologic and functional assessment are needed to define the appropriate limits of treatment de-intensification.

Comparison of Oncological Outcomes Between Open Radical Prostatectomy and Robotic-Assisted Radical Prostatectomy for Localized Prostate Carcinoma: A Systematic Review of Randomized Controlled Trials and Primary Studies

Introduction: Prostate carcinoma (PCa) is the second most frequently diagnosed malignancy in males globally, and radical prostatectomy (RP) constitutes the cornerstone of curative-intent surgical management for localized disease. Open radical prostatectomy (ORP) has been the historical gold standard; however, robotic-assisted radical prostatectomy (RARP) has experienced rapid, widespread adoption over the past two decades. Despite this diffusion, comparative oncological efficacy between the two platforms has remained under debate. This systematic review comprehensively compares oncological outcomes—including positive surgical margin (PSM) rates, biochemical recurrence (BCR), prostate cancer-specific survival (PCSS), overall survival (OS), and perioperative oncological parameters—between ORP and RARP for clinically localized PCa. Methods: The study strictly adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines. Eligible studies included randomized controlled trials (RCTs), cohort studies (prospective and retrospective), case-control studies, and cross-sectional observational studies directly comparing ORP with RARP in patients with clinically localized PCa. Risk of bias was evaluated using the Cochrane Risk of Bias 2 (RoB 2) tool for RCTs and the Newcastle-Ottawa Scale (NOS) for observational studies. Results: Twenty primary studies (3 RCTs, 17 observational cohort studies) encompassing >700,000 patients were included. RARP demonstrated lower PSM rates in the majority of large observational studies (OR 0.56–0.88, p<0.001 in several series), while results from RCTs were non-inferior but not significantly different. BCR rates were similar in RCTs (non-significant at 24–36 months), but long-term cohort data (12-year follow-up LAPPRO trial) demonstrated significantly lower PCSS-mortality in the RARP group (HR 0.36; 95% CI 0.23–0.55). RARP offered significant perioperative advantages: reduced estimated blood loss (192–250 vs. 710–852 mL), decreased transfusion rates, shorter hospitalization, fewer major postoperative complications, and lower 30-day mortality. Functional recovery of urinary continence and erectile function was superior in early time points for RARP, with equivalence observed at 24 months in RCTs. Discussion: The data synthesis from RCTs and large observational cohorts indicates that RARP is at least oncologically non-inferior to ORP across short- to medium-term follow-up periods, with accumulating long-term evidence suggesting potential superiority in PCSS. Perioperative and functional advantages of RARP are well-established. The surgeon learning curve, institutional volume, and patient risk stratification are critical confounders that must be considered when interpreting comparative data. The heterogeneity of follow-up durations and BCR definitions across studies constitutes a significant limitation of the current evidence base. Conclusion: RARP demonstrates oncological outcomes equivalent to ORP in short- and medium-term follow-up, with emerging long-term evidence supporting potential superiority in PCSS. Given its robust perioperative and functional advantages, RARP may be considered the preferred surgical approach for localized PCa in high-volume robotic centers. Large-scale, long-term RCTs remain necessary to definitively establish oncological equivalence or superiority.

Retrograde robot-assisted radical prostatectomy in a patient with localized prostate cancer: a case report

This case illustrates the practical application of the retrograde approach, emphasizing its anatomical rationale and technical considerations rather than demonstrating superiority over conventional antegrade nerve sparing in contemporary robot-assisted radical prostatectomy.

Global research trends in salvage robot-assisted radical prostatectomy: a bibliometric and visualization analysis

Overall, the field has progressed from demonstrating procedural feasibility toward evaluating patient-centered and longer-term clinical value, however, the continued prominence of “single institution” research and the concentration of output within expert centers may limit the generalizability of the evidence.