Intermediate-Term Oncologic Outcomes of Robot-Assisted Radical Cystectomy for Urothelial Carcinoma

Abstract

RARC provides an effective means of treatment of UCB in a minimally invasive fashion with comparable oncologic outcomes to that reported in the literature of open procedures.

Does Robot-Assisted Approach to Radical Cystectomy Influence Surgeon Choice for Urinary Diversion?

“…Whether the incorporation of RA technology has pushed surgeons towards ICs in favor of CUD remains unclear, especially when there is underutilization of CUD even among open surgeons. In our 10-year experience, only 32 (8%) patients received CUD, which is lower than previously reported in RA series [5,12]. Although this difference may be attributed in part by the patient and disease characteristics, surgeon and technology could still have a contribution.…”

Systematic Review and Cumulative Analysis of Oncologic and Functional Outcomes After Robot-assisted Radical Cystectomy

“…In series with median follow-up of >36 mo, rates of local recurrence without distant disease ranged between 0% (n = 15) and 9% (n = 99) [57,58,66,67,70]. No port-site recurrences occurred in these series.…”

“…Patients with a lymph node density of 1-10% (defined as number of positive nodes divided by number of total nodes) had DFS, CSS, and OS of 34%, 49%, and 31%, respectively, whereas patients with lymph node density >10% had further reduced survival of 30%, 38%, and 20%, respectively. Predictors of DFS were lymph node density, pathologic stage, and age-adjusted Charlson comorbidity index, whereas the same measures plus receipt of transfusion were predictive for OS [58]. Similarly, in an analysis of 99 patients with follow-up >5 yr, pathologic stage and lymph node positivity were independent predictors of DFS, CSS, and OS, whereas positive margin status and Charlson comorbidity index predicted worse OS and CSS [70].…”

“…Several series reported on adverse oncologic outcomes associated with increased pathologic stage or lymph node involvement [58,93]. In a series of 162 patients with urothelial carcinoma, Yuh et al found that 5-yr survival was worse with higher pathologic stage or lymph node positivity (p < 0.01).…”

Long-term Oncologic Outcomes Following Robot-assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium

“…Published series report outcomes from individual institutions with smaller numbers of patients, representative of selected patient cohorts [8][9][10]. The International Robotic Cystectomy Consortium (IRCC) has a prospectively populated quality-assurance database that contains >2000 RARC patients.…”