I'm beginning to believe (well, actually, I've believed this for quite some time) that it is NOT the treatment option, but the treatment provider who is the crucial factor in the outcome. Da Vinci seems to be used more and more (and in my opinion this makes perfect sense because of the extra resources made available by the robotic system), but this only means that more open RP surgeons are moving (and probably very reluctantly) to robotic, and are at the very bottom of their learning curve. This could explain the variability in RP outcomes.
Federal privacy legislation has been a boon to the less talented surgeons, as no one within the medical community wants to talk about any aspect of a patient's care -for fear of losing his or her job. So, no one is going to warn you about a poor surgeon, unless you are within the inner circle. People gossip, everyone knows -except you.
The Da Vinci robot DOES NOT carefully tease the nerves away from the prostate capsule, remove the prostate, and then re-make that all-important connection from the bladder neck to the urethra. The surgeon does this, using the tools the robot provides.
It follows then, that it is the surgeon who is responsible for the outcome. Some surgeons have consistently good outcomes. Doesn't it make sense that the newly diagnosed PC patient seek out this surgeon, if surgery is indeed his choice?
This argument probably holds true for the other methods of treatment.