Giorgio Gandaglia1,2,3, Ruben De Groote3, Nicolas Geurts3, Frederiek D'Hondt3, Francesco Montorsi2, Giacomo Novara1,4, Alexandre Mottrie1,3. 1. 1 OLV Vattikuti Robotic Surgery Institute , Melle, Belgium . 2. 2 Unit of Urology, Division of Oncology, URI, IRCCS Ospedale San Raffaele , Milan, Italy . 3. 3 Department of Urology, Onze-Lieve-Vrouw Hospital , Aalst, Belgium . 4. 4 Urology Clinic, Department of Surgery, Oncology, and Gastroenterology, University of Padua , Padua, Italy .
Abstract
BACKGROUND AND PURPOSE: The aim of our study was to assess the oncologic outcomes of robot-assisted radical cystectomy (RARC) in patients with bladder cancer (BCa) treated in a high-volume robotic center. MATERIALS AND METHODS: We retrospectively collected data of 155 consecutive patients who received RARC for urothelial BCa from January 2004 to May 2014. Kaplan-Meier analyses were used to assess time to recurrence, cancer-specific mortality (CSM) rate, and overall mortality rate. Uni- and multivariable Cox regression models addressed the predictors of recurrence and CSM. RESULTS: Median follow-up for survivors was 42 months. Overall, 43%, 34%, 55%, and 18% of the patients had pT ≤1, pT2, pT3/4, and pN1-3 disease, respectively. Overall, 76% of the patients had high-grade disease at final pathology. The positive surgical margin rate was 9%. The 5-year recurrence-free, CSM-free, and overall survival estimates were 53.7%, 73.5%, and 65.2%, respectively. Among patients who experienced recurrence, 12.0%, 4.0%, and 84.0% had local, peritoneal, and distant recurrence, respectively. In multivariable Cox regression analyses, pathologic stage and nodal status represented independent predictors of recurrence and CSM (all p ≤ 0.04). CONCLUSIONS: In a high-volume robotic center, RARC provides acceptable oncologic outcomes in patients with urothelial BCa. Tumor stage and nodal status represent independent predictors of recurrence and CSM in this setting.
BACKGROUND AND PURPOSE: The aim of our study was to assess the oncologic outcomes of robot-assisted radical cystectomy (RARC) in patients with bladder cancer (BCa) treated in a high-volume robotic center. MATERIALS AND METHODS: We retrospectively collected data of 155 consecutive patients who received RARC for urothelial BCa from January 2004 to May 2014. Kaplan-Meier analyses were used to assess time to recurrence, cancer-specific mortality (CSM) rate, and overall mortality rate. Uni- and multivariable Cox regression models addressed the predictors of recurrence and CSM. RESULTS: Median follow-up for survivors was 42 months. Overall, 43%, 34%, 55%, and 18% of the patients had pT ≤1, pT2, pT3/4, and pN1-3 disease, respectively. Overall, 76% of the patients had high-grade disease at final pathology. The positive surgical margin rate was 9%. The 5-year recurrence-free, CSM-free, and overall survival estimates were 53.7%, 73.5%, and 65.2%, respectively. Among patients who experienced recurrence, 12.0%, 4.0%, and 84.0% had local, peritoneal, and distant recurrence, respectively. In multivariable Cox regression analyses, pathologic stage and nodal status represented independent predictors of recurrence and CSM (all p ≤ 0.04). CONCLUSIONS: In a high-volume robotic center, RARC provides acceptable oncologic outcomes in patients with urothelial BCa. Tumor stage and nodal status represent independent predictors of recurrence and CSM in this setting.
Authors: Bernard H Bochner; Guido Dalbagni; Karim H Marzouk; Daniel D Sjoberg; Justin Lee; Sheri M Donat; Jonathan A Coleman; Andrew Vickers; Harry W Herr; Vincent P Laudone Journal: Eur Urol Date: 2018-05-18 Impact factor: 20.096
Authors: Vivek Venkatramani; Isildinha M Reis; Erik P Castle; Mark L Gonzalgo; Michael E Woods; Robert S Svatek; Alon Z Weizer; Badrinath R Konety; Mathew Tollefson; Tracey L Krupski; Norm D Smith; Ahmad Shabsigh; Daniel A Barocas; Marcus L Quek; Atreya Dash; Adam S Kibel; Raj S Pruthi; Jeffrey Scott Montgomery; Christopher J Weight; David S Sharp; Sam S Chang; Michael S Cookson; Gopal N Gupta; Alex Gorbonos; Edward M Uchio; Eila Skinner; Nachiketh Soodana-Prakash; Maria F Becerra; Sanjaya Swain; Kerri Kendrick; Joseph A Smith; Ian M Thompson; Dipen J Parekh Journal: J Urol Date: 2019-09-24 Impact factor: 7.450