Oncologic outcomes between open and robotic-assisted radical cystectomy: a propensity score matched analysis

Ahdoot, Michael; Almario, Leanne; Araya, Hiwot; Busch, Jonas; Conti, Simon; Gonzalgo, Mark L.

doi:10.1007/s00345-014-1242-4

Cited by 12 publications

(9 citation statements)

References 27 publications

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“…The characteristics of included studies are summarized in Table 1 . As for urinary diversion, sixteen adopted the extracorporeal method [ 6 , 7 , 9 – 17 , 20 , 22 – 25 ]. Similar neobladders were reconstructed between RARC and ORC groups (131 of 593 vs 125 of 654 in thirteen studies [ 6 , 7 , 9 – 14 , 16 , 17 , 23 – 25 ] (p = 0.08).…”

Section: Resultsmentioning

confidence: 99%

“…Since then, especially in the latest 5 years, RARC has gained its popularity and achieved decent long-term oncologic outcomes [ 4 , 5 ]. As to comparative analysis of complication rates and perioperative outcomes between RARC and ORC, different studies showed controversial results [ 6 – 20 ]. In 2012, Li et al [ 21 ] conducted a systematic review of literatures, with a meta-analysis of the results to compare RARC with ORC.…”

Section: Introductionmentioning

confidence: 99%

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Robotic versus Open Radical Cystectomy: An Updated Systematic Review and Meta-Analysis

Xia

Wang

et al. 2015

PLoS ONE

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ObjectiveTo critically review the currently available evidence of studies comparing robot-assisted radical cystectomy (RARC) with open radical cystectomy (ORC).MethodsA comprehensive review of the literature from Pubmed, Web of Science and Scopus was performed in April 2014. All relevant studies comparing RARC with ORC were included for further screening. A pooled meta-analysis of all comparative studies was performed and publication bias was assessed by a funnel plot.ResultsNineteen studies were included for the analysis, including a total of 1779 patients (787 patients in the RARC group and 992 patients in the ORC group). Although RARC was associated with longer operative time (p <0.0001), patients in this group might benefit from significantly lower overall perioperative complication rates within 30 days and 90 days (p = 0.005 and 0.0002, respectively), more lymph node yields (p = 0.009), less estimated blood loss (p <0.00001), lower need for perioperative and intraoperative transfusions (p <0.0001 and <0.0001, respectively), and shorter postoperative length of stay (p = 0.0002). There was no difference between two groups regarding positive surgical margin rates (p = 0.19).ConclusionsRARC appears to be an efficient alternative to ORC with advantages of less perioperative complications, more lymph node yields, less estimated blood loss, lower need for transfusions, and shorter postoperative length of stay. Further studies should be performed to compare the long-term oncologic outcomes between RARC and ORC.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Robotic versus Open Radical Cystectomy: An Updated Systematic Review and Meta-Analysis

Xia

Wang

et al. 2015

PLoS ONE

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“…Currently, radical cystectomy (RC) with bilateral pelvic lymphadenectomy is the primary treatment for patients with muscle‐invasive bladder cancer (BC) or refractory, high‐grade Ta, T1, Tis BC. To date several contemporary, single centre series of patients treated with RC for BC combined with bilateral lymphadenectomy have been published . However, very few report disease‐specific survival (DSS) as an endpoint.…”

Section: Introductionmentioning

confidence: 99%

Contemporary radical cystectomy outcomes in patients with invasive bladder cancer: a population‐based study

et al. 2015

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ObjectiveTo determine the contemporary survival outcomes from a whole population and identify significant predictors of survival, as contemporary population-based survival outcomes after radical cystectomy (RC) for the treatment of bladder cancer (BC) are sparse. Reports suggest a large disparity between population outcomes and those of centres of excellence. Patients and Methods ResultsOf 804 patients diagnosed during the study period 420 (52.2%) died during follow-up. The 5-year DSS and OS for all patients was 59.6% and 53.2%, respectively. The 5-year DSS for patients with localised, regional and distant disease, undergoing RC was 72%, 51% and 10%, respectively. Age (P < 0.001) and stage (P < 0.001) were associated with 5-year DSS and OS after adjusting for all other variables. High-volume centres had significantly better 5-year DSS compared with low-volume centres (P < 0.05). The 30-day mortality for high-vs low-volume centres was 1.8% and 3.6%, respectively. Perioperative mortality improved over time for high-and moderate-volume centres but not for low-volume centres. ConclusionContemporary survival outcomes after RC are much improved compared with older studies and appear close to results from academic centres of excellence. High-volume centres report better 5-year DSS outcomes than lower volume centres.

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“…Multiple studies report similar oncological outcomes at 5 years for robotic RC compared to open RC. [37383940] Oncological outcomes have been subject to heavy criticism because of selection bias. [4142] However, multiple studies have reported advanced pathology treated with robotic RC has similar oncological outcomes to advanced pathology treated with open RC.…”

Section: Advances In Surgery For Muscle Invasive Bladder Cancermentioning

confidence: 99%

“…[4142] However, multiple studies have reported advanced pathology treated with robotic RC has similar oncological outcomes to advanced pathology treated with open RC. [3738394041] In addition, there is no difference in lymph node yield between the two modalities. [43]…”

Section: Advances In Surgery For Muscle Invasive Bladder Cancermentioning

confidence: 99%

Advances in surgical management of muscle invasive bladder cancer

Kukreja

Shah

2017

Indian J Urol

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Introduction:Bladder cancer remains a disease of the elderly with relatively few advances that have improved survival over the last 20 years. Radical cystectomy (RC) has long remained the principal treatment for muscle-invasive bladder cancer (MIBC).Methods:A literature search of PubMed was performed. The content was reviewed for continuity with the topic of surgical advances in MIBC. Articles and society guidelines were included in this review.Results:Despite the associated morbidity, even in the elderly, RC is still a reasonable option. Modifications during RC may have a positive or negative impact on survival and quality of life. The extent of pelvic lymph node dissection is one such factor which may positively impact survival outcomes. In addition, preservation of pelvic organs, robotic surgery and the adoption of enhanced recovery after surgery principles continues to improve the postoperative recovery and quality of life in RC patients.Conclusion:There are some ongoing studies in many of these areas, but overall the new advances in MIBC may improve patient quality and quantity of life. The advances in surgical treatment of MIBC are important and the focus of the review here.

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Oncologic outcomes between open and robotic-assisted radical cystectomy: a propensity score matched analysis

Cited by 12 publications

References 27 publications

Robotic versus Open Radical Cystectomy: An Updated Systematic Review and Meta-Analysis

Robotic versus Open Radical Cystectomy: An Updated Systematic Review and Meta-Analysis

Contemporary radical cystectomy outcomes in patients with invasive bladder cancer: a population‐based study

Advances in surgical management of muscle invasive bladder cancer

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