Long-term Outcomes of Robot-assisted Radical Cystectomy for Bladder Cancer

Abstract Background: With the rapid development of surgical technics and instruments, more and more bladder cancer patients are being treated by laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) .The aim of this retrospective study was to compare the perioperative and long-term outcomes of patients who underwent cystectomy by these two surgical approaches. Methods: We performed a retrospective review of the prospectively collected database of our hospital to identify patients with clinical stage Ta/T1/Tis to T3 who underwent RARC and LRC. Perioperative outcomes, recurrence, and overall survival (OS) were analyzed. Results: From March 2010 to December 2019, there were total of 218 patients, which including 82(38%) patients with LRC and 136(62%) patients with RARC. No perioperative death was observed in both groups. Tumor recurrence, death from any causes, and cancer-specific death occurred in 77, 55, and 39 patients respectively. The 5-year DFS, OS, and CSS rates for all included patients were 55.4%, 62.4%, and 66.4%, respectively. There were no significantly statistically differences between the RARC group and the LRC group for number of lymph nodes harvested, positive lymph node rate, positive margin rate and postoperative pathological stage (all P>0.05). Patients undergoing RARC had lower median estimated blood loss (180mL vs. 250 mL; P 0.015) and 90-days postoperative complications (30.8% vs. 46.3%; P 0.013) than LRC.Conclusions: For selected patients with RARC and LRC, both were safe and effective with a low complication rate and similar long-term outcome compared two groups. Moreover, the robotic approach resulted in lower median estimated blood loss and better outcome in postoperative complications.

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Robot-Assisted, Laparoscopic, and Open Radical Cystectomy (RC): Pre-Operative Data of 1400 Patients From The Italian Radical Cystectomy Registry (RIC)

10.21203/rs.3.rs-449403/v1 ◽

2021 ◽

Author(s):

Angelo Porreca ◽

Gian Maria Busetto ◽

Michele Colicchia ◽

Katie Palmer ◽

Walter Artibani ◽

...

Keyword(s):

Radical Cystectomy ◽

Patient Characteristics ◽

Long Term Outcomes ◽

Robot Assisted ◽

Clinical Variables ◽

Stage Classification ◽

Short And Long Term ◽

Open Radical Cystectomy

Abstract Introduction: the Italian Radical Cystectomy Registry (RIC) is an observational prospective study aiming to understand clinical variables and patient characteristics associated with short- and long-term outcomes among bladder cancer (BC) patients undergoing radical cystectomy (RC). Moreover, it compares the effectiveness of three RC techniques - open, robotic, and laparoscopic.Methods: from 2017 to 2020, 1400 patients were enrolled at one of the 28 centers across Italy. Patient characteristics, as well as preoperative, postoperative, and follow-up (3, 6, 12, and 24 months) clinical variables and outcomes were collected. Results: preoperatively, it was found that patients undergoing robotic procedures were younger (p<.001) and more likely to have undergone preoperative neoadjuvant chemotherapy (p<.001) and BCG instillation (p<.001). Hypertension was the most common comorbidity among all patients (55%), and overall, patients undergoing open and laparoscopic RC had a higher Charlson Comorbidities Index (CCI) compared to robotic RC (p<.001). Finally, laparoscopic patients had a lower G-stage classification (p=.003) and open patients had a higher ASA score (p<.001). Conclusion: the present study summarizes the characteristic of patients included in the RIC. Future results will provide invaluable information about outcomes among BC patients undergoing RC. This will inform physicians about the best techniques and course of care based on patient clinical factors and characteristics.

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Long-term outcomes in bladder-preserving patients with muscle-invasive bladder cancer comparing radical cystectomy by propensity score-match analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.15_suppl.e15530 ◽

2015 ◽

Vol 33 (15_suppl) ◽

pp. e15530-e15530

Author(s):

Hideyasu Matsuyama ◽

Kazuhiro Nagao ◽

Takahiko Hara ◽

Keita Kobayashi ◽

Keyword(s):

Bladder Cancer ◽

Propensity Score ◽

Radical Cystectomy ◽

Propensity Score Match ◽

Long Term Outcomes ◽

Match Analysis ◽

Muscle Invasive Bladder Cancer ◽

Propensity Score Match Analysis ◽

Muscle Invasive

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Long-term outcomes of patients with locally advanced bladder cancer that underwent intra-arterial chemotherapy with/without radiotherapy for organ preservation.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.6_suppl.574 ◽

2020 ◽

Vol 38 (6_suppl) ◽

pp. 574-574

Author(s):

Tomohiro Matsuo ◽

Yasuyoshi Miyata ◽

Kensuke Mitsunari ◽

Kojiro Ohba ◽

Hideki Sakai

Keyword(s):

Bladder Cancer ◽

Radical Cystectomy ◽

Organ Preservation ◽

Locally Advanced ◽

Survival Rates ◽

Long Term Outcomes ◽

Bladder Preservation ◽

Advanced Bladder Cancer ◽

Better Than

574 Background: We previously reported efficacy and safety of intra-arterial chemotherapy with/without radiotherapy in patients with locally advanced bladder cancer. However, there was no data on long-term outcomes, such as organ preservation, subsequently metastasis, and survival of such therapy. In this study, we investigated outcomes of intra-arterial chemotherapy with/without radiotherapy in these patients for long term periods. Methods: In this study, we investigated 129 patients who treated with intra-vesical chemotherapy (n = 50) and intra-arterial chemotherapy and radiotherapy (n = 79). There was no significant difference on age at diagnosis, gender, grade, and T stage between these two groups. Mean/median follow up periods in intra-vesical chemotherapy (n = 50) and intra-arterial chemotherapy with radiotherapy was 86.5/101 and 107.7/122 months. Results: Rates of bladder preservation in intra-arterial therapy and intra-arterial therapy with radiotherapy are 66.0 and 82.3%, respectively (P = 0.035), and Kaplan-Meier survival curves showed that intra-arterial therapy with radiotherapy had better than intra-arterial therapy (P = 0.007). On the other hand, subsequently metastasis-free survival rates in intra-arterial therapy with radiotherapy was significantly better than those with intra-arterial therapy (P = 0.037). Regrading cause-specific survival, the survival period in intra-arterial therapy with radiotherapy was significantly better than that in intra-arterial therapy (P < 0.001). In addition, even if radical cystectomy was performed, the survival rates after the operation in intra-arterial therapy with radiotherapy was significantly better than that in intra-arterial therapy (P = 0.002). There was no sever complication at late phase (over 5 years). Conclusions: Our results showed that intra-arterial therapy with radiotherapy showed better outcomes of bladder preservation, subsequently metastasis, and survival. In addition, in patients locally advanced bladder cancer received radical cystectomy, intra-arterial therapy with radiotherapy had better prognosis compared to intra-arterial therapy.

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