OBJECTIVE: To propose a standardisable composite method for reporting outcomes of radical cystectomy (RC) that incorporates both perioperative morbidity and oncological adequacy. PATIENTS AND METHODS: From July 2010 to December 2017, 277 consecutive patients who underwent robot-assisted RC with intracorporeal urinary diversion (UD) for bladder cancer at our Institution were prospectively analysed. Patients who simultaneously demonstrated negative soft tissue surgical margins (STSMs), ≥16 lymph node (LN) yield, absence of major (grade III-IV) complications at 90 days, absence of UD-related long-term sequelae and absence of clinical recurrence at ≤12 months, were considered as having achieved the RC-pentafecta. A multivariable logistic regression model was assessed to measure predictors for achieving RC-pentafecta. RESULTS AND LIMITATIONS: Since 2010, 270 of 277 patients that had completed at least 12 months of follow-up were included. Over a mean follow-up of 22.3 months, ≥16 LN yield, negative STSMs, absence of major complications at 90 days, and absence of UD-related surgical sequelae and clinical recurrence at ≤12 months were observed in 93.0%, 98.9%, 76.7%, 81.5% and 92.2%, patients, respectively, resulting in a RC-pentafecta rate of 53.3%. Multivariable logistic regression analysis revealed age (odds ratio [OR] 0.95; P = 0.002), type of UD (OR 2.19; P = 0.01) and pN stage (OR 0.48; P = 0.03) as independent predictors for achieving RC-pentafecta. CONCLUSIONS: We present a RC-pentafecta as a standardisable composite endpoint that incorporates perioperative morbidity and oncological adequacy as a potential tool to assess quality of RC. This tool may be useful for assessing the learning curve and calculating cost-effectiveness amongst others but needs to be externally validated in future studies.
OBJECTIVE: To propose a standardisable composite method for reporting outcomes of radical cystectomy (RC) that incorporates both perioperative morbidity and oncological adequacy. PATIENTS AND METHODS: From July 2010 to December 2017, 277 consecutive patients who underwent robot-assisted RC with intracorporeal urinary diversion (UD) for bladder cancer at our Institution were prospectively analysed. Patients who simultaneously demonstrated negative soft tissue surgical margins (STSMs), ≥16 lymph node (LN) yield, absence of major (grade III-IV) complications at 90 days, absence of UD-related long-term sequelae and absence of clinical recurrence at ≤12 months, were considered as having achieved the RC-pentafecta. A multivariable logistic regression model was assessed to measure predictors for achieving RC-pentafecta. RESULTS AND LIMITATIONS: Since 2010, 270 of 277 patients that had completed at least 12 months of follow-up were included. Over a mean follow-up of 22.3 months, ≥16 LN yield, negative STSMs, absence of major complications at 90 days, and absence of UD-related surgical sequelae and clinical recurrence at ≤12 months were observed in 93.0%, 98.9%, 76.7%, 81.5% and 92.2%, patients, respectively, resulting in a RC-pentafecta rate of 53.3%. Multivariable logistic regression analysis revealed age (odds ratio [OR] 0.95; P = 0.002), type of UD (OR 2.19; P = 0.01) and pN stage (OR 0.48; P = 0.03) as independent predictors for achieving RC-pentafecta. CONCLUSIONS: We present a RC-pentafecta as a standardisable composite endpoint that incorporates perioperative morbidity and oncological adequacy as a potential tool to assess quality of RC. This tool may be useful for assessing the learning curve and calculating cost-effectiveness amongst others but needs to be externally validated in future studies.
Authors: Iulia Andras; Angelo Territo; Teodora Telecan; Paul Medan; Ion Perciuleac; Alexandru Berindean; Dan V Stanca; Maximilian Buzoianu; Ioan Coman; Nicolae Crisan Journal: J Clin Med Date: 2021-04-21 Impact factor: 4.241
Authors: Łukasz Zapała; Aleksander Ślusarczyk; Bartłomiej Korczak; Paweł Kurzyna; Mikołaj Leki; Piotr Lipiński; Jerzy Miłow; Michał Niemczyk; Kamil Pocheć; Michał Późniak; Maciej Przudzik; Tomasz Suchojad; Rafał Wolański; Piotr Zapała; Tomasz Drewa; Marek Roslan; Waldemar Różański; Andrzej Wróbel; Piotr Radziszewski Journal: Front Oncol Date: 2022-01-26 Impact factor: 6.244
Authors: Frederik König; Nico C Grossmann; Francesco Soria; David D'Andrea; Tristan Juvet; Aaron Potretzke; Hooman Djaladat; Alireza Ghoreifi; Eiji Kikuchi; Nozomi Hayakawa; Andrea Mari; Zine-Eddine Khene; Kazutoshi Fujita; Jay D Raman; Alberto Breda; Matteo Fontana; John P Sfakianos; John L Pfail; Ekaterina Laukhtina; Pawel Rajwa; Maximilian Pallauf; Giovanni E Cacciamani; Thomas van Doeveren; Joost L Boormans; Alessandro Antonelli; Marcus Jamil; Firas Abdollah; Jeffrey Budzyn; Guillaume Ploussard; Axel Heidenreich; Siamak Daneshmand; Stephen A Boorjian; Morgan Rouprêt; Michael Rink; Shahrokh F Shariat; Benjamin Pradere Journal: Cancers (Basel) Date: 2022-03-31 Impact factor: 6.639
Authors: Francesco Soria; B Pradere; R Hurle; D D'Andrea; S Albisinni; R Diamand; E Laukhtina; E Di Trapani; A Aziz; W Krajewski; J Y Teoh; A Mari; M Moschini; F Chiancone; R Autorino; A Porreca; M Marchioni; G Liguori; G Lucarelli; G M Busetto; N Foschi; A Antonelli; P Bove; G I Russo; N Crisan; M Borghesi; L Boeri; A Veccia; F Greco; N Longo; O De Cobelli; S F Shariat; P Gontero; M Ferro Journal: Eur Urol Open Sci Date: 2022-06-13
Authors: P Baron; Z Khene; F Lannes; G Pignot; A S Bajeot; G Ploussard; G Verhoest; A Gasmi; O Perrot; M Roumiguie; K Mori; G E Cacciamani; M Rouprêt; F Bruyère; B Pradere Journal: World J Urol Date: 2021-07-03 Impact factor: 4.226