Robotic versus open radical cystectomy throughout the learning phase: insights from a real-life multicenter study

Background and objectives Robot-assisted radical cystectomy (RARC) has been shown to be non-inferior to open radical cystectomy (ORC) for the treatment of bladder cancer (BC). However, most data on RARC come from high-volume surgeons at high-volume centers. The objective of the study was to compare...

Full description

Saved in:
Bibliographic Details
Published in:World journal of urology 2020-08, Vol.38 (8), p.1951-1958
Main Authors: Lenfant, Louis, Campi, Riccardo, Parra, Jérôme, Graffeille, Vivien, Masson-Lecomte, Alexandra, Vordos, Dimitri, de La Taille, Alexandre, Roumiguie, Mathieu, Lesourd, Marine, Taksin, Lionel, Misraï, Vincent, Granger, Benjamin, Ploussard, Guillaume, Vaessen, Christophe, Verhoest, Gregory, Rouprêt, Morgan
Format: Article
Language:English
Subjects:
Aged
Bladder cancer
Cancer
Chemotherapy
Cystectomy - methods
Female
Humans
Invasiveness
Lymph nodes
Male
Medicine
Medicine & Public Health
Middle Aged
Nephrology
Observational learning
Oncology
Original Article
Postoperative Complications - epidemiology
Retrospective Studies
Robotic surgery
Robotic Surgical Procedures - education
Surgeons
Time Factors
Treatment Outcome
Tumors
Urinary Bladder Neoplasms - surgery
Urology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background and objectives Robot-assisted radical cystectomy (RARC) has been shown to be non-inferior to open radical cystectomy (ORC) for the treatment of bladder cancer (BC). However, most data on RARC come from high-volume surgeons at high-volume centers. The objective of the study was to compare perioperative and mid-term oncologic outcomes of RARC versus ORC in a real-life cohort of patients treated by surgeons starting their experience with RARC. Materials and methods Data were prospectively collected from consecutive patients undergoing RARC and ORC at five referral Centers between 2010 and 2016 by five surgeons (one per center) with no prior experience in RARC. Patients with high-risk non-muscle-invasive or organ-confined muscle-invasive (T2N0M0) bladder cancer were considered for RARC. The main study endpoints were perioperative outcomes, postoperative surgical complications, and mid-term oncologic outcomes. Results Overall, 124 and 118 patients underwent RARC and ORC, respectively. Baseline patients’ and tumors’ characteristics were comparable between the two groups. Yet, the proportion of patients receiving neoadjuvant chemotherapy was significantly higher in the RARC cohort. Median operative time was significantly higher, while median EBL, LOH, and transfusion rates were significantly lower after RARC. Median number of lymph nodes removed was significantly higher after RARC. All other histopathological outcomes, as well as the rate of early (
ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-019-02998-y