Michael Owyong1, Tulay Koru-Sengul2, Feng Miao3, Shirin Razdan1, Kevin J Moore4, Mahmoud Alameddine1, Sanoj Punnen5, Dipen J Parekh5, Chad R Ritch5, Mark L Gonzalgo6. 1. Department of Urology, University of Miami Miller School of Medicine, Miami, FL. 2. Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL. 3. Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL. 4. Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL. 5. Department of Urology, University of Miami Miller School of Medicine, Miami, FL; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL. 6. Department of Urology, University of Miami Miller School of Medicine, Miami, FL; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL. Electronic address: m.gonzalgo@miami.edu.
Abstract
INTRODUCTION: We assessed the impact of open or minimally-invasive partial cystectomy on surgical margin status in a nationwide hospital-based cohort. MATERIALS AND METHODS: Patients who underwent partial cystectomy from 2010 to 2014 were identified in the National Cancer Data Base. The primary outcome was surgical margin status. A multivariable logistic regression model was fitted to identify patient, hospital, and surgical factors associated with positive surgical margins (PSMs). RESULTS: Partial cystectomy was performed in 1,118 patients via open (n = 715, 64%), laparoscopic (n = 209, 19%), and robotic (n = 194, 17%) approaches. Overall, 220 (19.7%) patients had PSMs. The PSM rate by surgical approach was 19.6% for open, 18.2% for laparoscopic, and 21.6% for robotic (P = 0.678). Compared to open partial cystectomy, the laparoscopic (aOR 1.06, 95%CI 0.70-1.60, P = 0.782), and robotic (aOR 1.28, 95%CI 0.85-1.91, P = 0.235) approaches were not significantly different in terms of PSM rate. There were higher odds of PSMs in non-Hispanic blacks (aOR 1.93, 95%CI 1.09-3.39, P = 0.023) compared to non-Hispanic whites, and in patients with muscle invasive bladder cancer (aOR 3.28, 95%CI 2.00-5.37, P < 0.001) or tumor size ≥ 3 cm (aOR 1.67, 95%CI 1.21-2.30, P = 0.002). Tumors in a dome/urachal location had lower odds of a PSM compared to tumors in a nondome/urachal location (aOR 0.67, 95%CI 0.47-0.94, P = 0.022). CONCLUSIONS: Our results suggest that partial cystectomy using a laparoscopic or robotic-assisted approach is not associated with an increased risk of PSMs compared to open partial cystectomy.
INTRODUCTION: We assessed the impact of open or minimally-invasive partial cystectomy on surgical margin status in a nationwide hospital-based cohort. MATERIALS AND METHODS:Patients who underwent partial cystectomy from 2010 to 2014 were identified in the National Cancer Data Base. The primary outcome was surgical margin status. A multivariable logistic regression model was fitted to identify patient, hospital, and surgical factors associated with positive surgical margins (PSMs). RESULTS: Partial cystectomy was performed in 1,118 patients via open (n = 715, 64%), laparoscopic (n = 209, 19%), and robotic (n = 194, 17%) approaches. Overall, 220 (19.7%) patients had PSMs. The PSM rate by surgical approach was 19.6% for open, 18.2% for laparoscopic, and 21.6% for robotic (P = 0.678). Compared to open partial cystectomy, the laparoscopic (aOR 1.06, 95%CI 0.70-1.60, P = 0.782), and robotic (aOR 1.28, 95%CI 0.85-1.91, P = 0.235) approaches were not significantly different in terms of PSM rate. There were higher odds of PSMs in non-Hispanic blacks (aOR 1.93, 95%CI 1.09-3.39, P = 0.023) compared to non-Hispanic whites, and in patients with muscle invasive bladder cancer (aOR 3.28, 95%CI 2.00-5.37, P < 0.001) or tumor size ≥ 3 cm (aOR 1.67, 95%CI 1.21-2.30, P = 0.002). Tumors in a dome/urachal location had lower odds of a PSM compared to tumors in a nondome/urachal location (aOR 0.67, 95%CI 0.47-0.94, P = 0.022). CONCLUSIONS: Our results suggest that partial cystectomy using a laparoscopic or robotic-assisted approach is not associated with an increased risk of PSMs compared to open partial cystectomy.
Authors: Azadeh Stark; Celina G Kleer; Iman Martin; Baffour Awuah; Anthony Nsiah-Asare; Valerie Takyi; Maria Braman; Solomon E Quayson; Richard Zarbo; Max Wicha; Lisa Newman Journal: Cancer Date: 2010-11-01 Impact factor: 6.860
Authors: G R Prout; M N Wesley; R S Greenberg; V W Chen; C C Brown; A W Miller; R S Weinstein; S J Robboy; M A Haynes; R S Blacklow; B K Edwards Journal: Cancer Date: 2000-09-15 Impact factor: 6.860
Authors: Jeffrey M Holzbeierlein; Ernesto Lopez-Corona; Bernard H Bochner; Harry W Herr; S Machele Donat; Paul Russo; Guido Dalbagni; Pramod C Sogani Journal: J Urol Date: 2004-09 Impact factor: 7.450
Authors: Wassim M Bazzi; Ryan P Kopp; Timothy F Donahue; Melanie Bernstein; Paul Russo; Bernard H Bochner; Sherri M Donat; Guido Dalbagni; Harry W Herr Journal: Int Sch Res Notices Date: 2014-11-13
Authors: Davide Loizzo; Savio D Pandolfo; Fabio Crocerossa; Georgi Guruli; Matteo Ferro; Asit K Paul; Ciro Imbimbo; Giuseppe Lucarelli; Pasquale Ditonno; Riccardo Autorino Journal: Eur Urol Open Sci Date: 2022-03-14