Open Versus Robotic Cystectomy: A Propensity Score Matched Analysis Comparing Survival Outcomes.

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2019
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Abstract
To assess the differential effect of robotic assisted radical cystectomy (RARC) versus open radical cystectomy (ORC) on survival outcomes in matched analyses performed on a large multicentric cohort.The study included 9757 patients with urothelial bladder cancer (BCa) treated in a consecutive manner at each of 25 institutions. All patients underwent radical cystectomy with bilateral pelvic lymphadenectomy. To adjust for potential selection bias, propensity score matching 2:1 was performed with two ORC patients matched to one RARC patient. The propensity-matched cohort included 1374 patients. Multivariable competing risk analyses accounting for death of other causes, tested association of surgical technique with recurrence and cancer specific mortality (CSM), before and after propensity score matching.Overall, 767 (7.8%) patients underwent RARC and 8990 (92.2%) ORC. The median follow-up before and after propensity matching was 81 and 102 months, respectively. In the overall population, the 3-year recurrence rates and CSM were 37% vs. 26% and 34% vs. 24% for ORC vs. RARC (all values > 0.1), respectively. On multivariable Cox regression analyses, RARC and ORC had similar recurrence and CSM rates before and after matching (all values > 0.1).Patients treated with RARC and ORC have similar survival outcomes. This data is helpful in consulting patients until long term survival outcomes of level one evidence is available.
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Authors Moschini, Marco;Zamboni, Stefania;Soria, Francesco;Mathieu, Romain;Xylinas, Evanguelos;Tan, Wei Shen;Kelly, John D;Simone, Giuseppe;Meraney, Anoop;Krishna, Suprita;Konety, Badrinath;Mattei, Agostino;Baumeister, Philipp;Mordasini, Livio;Montorsi, Francesco;Briganti, Alberto;Gallina, Andrea;Stabile, Armando;Sanchez-Salas, Rafael;Cathelineau, Xavier;Rink, Michael;Necchi, Andrea;Karakiewicz, Pierre I;Rouprêt, Morgan;Koupparis, Anthony;Kassouf, Wassim;Scherr, Douglas S;Ploussard, Guillaume;Boorjian, Stephen A;Lotan, Yair;Sooriakumaran, Prasanna;Shariat, Shahrokh F;
Journal journal of clinical medicine
Year 2019
DOI
E1192
URL
Keywords
survival bladder cancer open propensity score radical cystectomy robotic-assisted weight ramadan energy expenditure fast intermittent bone tissue engineering bioactivity sol-gel calcium(ii) release hybrid glass scaffolds

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