Ahmed A Hussein1, Ahmed S Elsayed1, Naif A Aldhaam1, Zhe Jing1, Jennifer Osei1, Jihad Kaouk2, Juan Palou Redorta3, Mani Menon4, James Peabody4, Prokar Dasgupta5, Mohammed Shamim Khan5, Alexandre Mottrie6, Michael Stöckle7, Ashok Hemal8, Lee Richstone9, Abolfazl Hosseini10, Peter Wiklund10, Francis Schanne11, Eric Kim12, Koon Ho Rha13, Khurshid A Guru1. 1. Roswell Park Comprehensive Cancer Center, New York, New York. 2. Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio. 3. Fundació Puigvert, Barcelona, Spain. 4. Henry Ford Health System, Detroit, Michigan. 5. Guy's Hospital and King's College London School of Medicine, London, United Kingdom. 6. Onze-Lieve-Vrouw Ziekenhuis, Aalast, Belgium. 7. University of the Saarland, Homburg Saar, Germany. 8. Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina. 9. Arthur Smith Institute for Urology, New York, New York. 10. Karolinska Institute, Stockholm, Sweden. 11. Urological Surgical Associates of Delaware, Wilmington, Delaware. 12. Washington University School of Medicine, St. Louis, Missouri. 13. Yonsei Medical Health System, Seoul, South Korea.
Abstract
PURPOSE: Radical cystectomy is the gold standard for nonmetastatic muscle invasive bladder cancer and for refractory nonmuscle invasive disease. Compared to open radical cystectomy, robot-assisted radical cystectomy has been shown to provide comparable early oncologic outcomes and improved perioperative outcomes. However, there is a paucity of data on long-term oncologic outcomes and concerns about a higher incidence of local recurrence after robot-assisted radical cystectomy. We report 10-year oncologic outcomes following robot-assisted radical cystectomy using a multinational database. MATERIALS AND METHODS: We retrospectively reviewed the prospective International Robotic Cystectomy Consortium database. Consecutive patients who underwent robot-assisted radical cystectomy 10 years ago or earlier were included in analysis. Data were reviewed for demographics, and perioperative, pathological and oncologic outcomes. Kaplan-Meier curves were used to depict recurrence-free, disease specific and overall survival. Multivariate stepwise Cox regression models were applied to identify variables associated with recurrence-free, disease specific and overall survival. RESULTS: We identified 446 patients with a median age of 67 years (IQR 59-76). Of the patients 10% received neoadjuvant chemotherapy, 51% experienced any complication, 23% had high grade complications and 4% died within 3 months of robot-assisted radical cystectomy. Disease was pT3 or greater in 43% of patients and pN+ in 24% while a positive soft tissue surgical margin was observed in 7%. At a median followup of 5 years (IQR 2-10, maximum 14) local and distant recurrence had developed in 15% and 29% of patients, respectively. Ten-year recurrence-free, disease specific and overall survival rates were 59%, 65% and 35%, respectively. Patients with pT3 or greater and pN+ disease showed worse recurrence-free, disease specific and overall survival. CONCLUSIONS: Long-term oncologic outcomes, and recurrence rates and patterns after robot-assisted radical cystectomy seem comparable to those in open series. Advanced disease stage and positive surgical margins remain the main determinants of survival after radical cystectomy.
PURPOSE: Radical cystectomy is the gold standard for nonmetastatic muscle invasive bladder cancer and for refractory nonmuscle invasive disease. Compared to open radical cystectomy, robot-assisted radical cystectomy has been shown to provide comparable early oncologic outcomes and improved perioperative outcomes. However, there is a paucity of data on long-term oncologic outcomes and concerns about a higher incidence of local recurrence after robot-assisted radical cystectomy. We report 10-year oncologic outcomes following robot-assisted radical cystectomy using a multinational database. MATERIALS AND METHODS: We retrospectively reviewed the prospective International Robotic Cystectomy Consortium database. Consecutive patients who underwent robot-assisted radical cystectomy 10 years ago or earlier were included in analysis. Data were reviewed for demographics, and perioperative, pathological and oncologic outcomes. Kaplan-Meier curves were used to depict recurrence-free, disease specific and overall survival. Multivariate stepwise Cox regression models were applied to identify variables associated with recurrence-free, disease specific and overall survival. RESULTS: We identified 446 patients with a median age of 67 years (IQR 59-76). Of the patients 10% received neoadjuvant chemotherapy, 51% experienced any complication, 23% had high grade complications and 4% died within 3 months of robot-assisted radical cystectomy. Disease was pT3 or greater in 43% of patients and pN+ in 24% while a positive soft tissue surgical margin was observed in 7%. At a median followup of 5 years (IQR 2-10, maximum 14) local and distant recurrence had developed in 15% and 29% of patients, respectively. Ten-year recurrence-free, disease specific and overall survival rates were 59%, 65% and 35%, respectively. Patients with pT3 or greater and pN+ disease showed worse recurrence-free, disease specific and overall survival. CONCLUSIONS: Long-term oncologic outcomes, and recurrence rates and patterns after robot-assisted radical cystectomy seem comparable to those in open series. Advanced disease stage and positive surgical margins remain the main determinants of survival after radical cystectomy.
Authors: Hyun Jung Jin; Ji Sung Shim; Tae Gyun Kwon; Tae-Hwan Kim; Seung Hyun Jeon; Sang Hyub Lee; Sung Gu Kang; Jong Kil Nam; Wan Suk Kim; Byung Chang Jeong; Jong Jin Oh; Sang Chul Lee; Ji Youl Lee; Sung-Hoo Hong; Koon Ho Rha; Woong Kyu Han; Won Sik Ham; Young Goo Lee; Yong Seong Lee; Sung Yul Park; Young Eun Yoon; Ja Hyeon Ku; Seok Ho Kang Journal: Investig Clin Urol Date: 2022-01
Authors: Satoshi Katayama; Keiichiro Mori; Benjamin Pradere; Hadi Mostafaei; Victor M Schuettfort; Fahad Quhal; Reza Sari Motlagh; Ekaterina Laukhtina; Marco Moschini; Nico C Grossmann; Yasutomo Nasu; Shahrokh F Shariat; Harun Fajkovic Journal: Int J Clin Oncol Date: 2021-06-19 Impact factor: 3.402