Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct;15(5):773-780.
doi: 10.1007/s11701-020-01175-3. Epub 2020 Nov 23.

Comparison of long-term outcomes in a 10-year experience of robotic cystectomy vs. open cystectomy

Kevan L Ip  1 , Juan F Javier-DesLoges  1 , Cynthia Leung  1 , James Nie  1 , Ghazal Khajir  1 , Cayce B Nawaf  1 , Jamil Syed  1 , James S Rosoff  1 , Thomas V Martin  1 , David G Hesse  2
Affiliations

Comparison of long-term outcomes in a 10-year experience of robotic cystectomy vs. open cystectomy

Kevan L Ip et al. J Robot Surg. 2021 Oct.

Abstract

To compare the outcomes of robotic-assisted (RARC) vs. open radical cystectomy (ORC) at a single academic institution. We retrospectively identified patients undergoing radical cystectomy for urothelial carcinoma of the bladder at our institution from 2007 to 2017. Data collected included age, sex, Body Mass Index (BMI), Charlson Age-Adjusted Comorbidity Index (CCI), final pathologic stage, surgical margins, lymph-node yield, estimated blood loss (EBL), 90-day complication rate, and length of stay (LOS). We evaluated overall survival (OS) and recurrence-free survival (RFS). Multivariable Cox proportional hazard models were used to adjust for covariates. We identified 232 patients (73 RARC, 159 ORC) who underwent radical cystectomy. Patients who underwent RARC were older (71.8 vs. 67.5, p < 0.05) and had higher CCI scores (6.2 vs. 5.3, p < 0.05). In comparing perioperative outcomes, RARC patients had lower EBL (500 vs. 850, p < 0.01), lower blood transfusion rate (p < 0.01), and lower lymph-node yield (12 vs. 20, p < 0.01), and higher ICU admission rate (29% vs. 16% p < 0.01). There was no difference in BMI (p = 0.93), sex (p = 0.28), final pathological stage (p = 0.35), positive surgical margins (p = 0.47), complications (p = 0.58), or LOS (p = 0.34). Kaplan-Meier analysis showed no difference in OS (p = 0.26) or RFS (p = 0.86). There was no difference in restricted mean survival time for OS (53 vs. 56 months, p = 0.81) or for RFS (65 vs. 64 months, p = 0.90). Cox multivariate regression models showed that surgical approach does not have a significant impact on OS (p = 0.46) or RFS (p = 0.35). Our study indicates that in our 10-year experience, patients undergoing there was no difference between RARC and ORC patients with respect to OS and RFS despite being older and having more comorbidities. Our work supports the importance of patient selection to optimize outcomes.

Keywords: Bladder cancer; Open radical cystectomy; Radical cystectomy; Robot-assisted radical cystectomy.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Howlader N, Noone AM, Krapcho M, et al (2019) SEER Cancer Statistics Review, 1975–2016, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2016/ . Based on November 2018 SEER data submission, posted to the SEER website, April 2019.
    1. Siegel RL, Miller KD, Jemal A (2017) Cancer statistics, 2017. CA Cancer J Clin 67:7–30 - DOI
    1. Hounsome LS, Verne J, McGrath JS, Gillatt DA (2015) Trends in operative caseload and mortality rates after radical cystectomy for bladder cancer in England for 1998–2010. Eur Urol 67:1056–1062. https://doi.org/10.1016/j.eururo.2014.12.002 - DOI - PubMed
    1. Shariat SF, Karakiewicz PI, Palapattu GS, Lotan Y, Rogers CG, Amiel GE, Vazina A, Gupta A, Bastian PJ, Sagalowsky AI et al (2006) Outcomes of radical cystectomy for transitional cell carcinoma of the bladder. J Urol 176:2414–2422 - DOI
    1. Bachman AG, Parker AA, Shaw MD, Cross BW, Stratton KL, Cookson MS, Patel SG (2017) Minimally invasive versus open approach for cystectomy: trends in the utilization and demographic or clinical predictors using the national cancer database. Urology 103:99–105. https://doi.org/10.1016/j.urology.2017.02.018 - DOI - PubMed

MeSH terms

LinkOut - more resources