Bladder cancer: minimal invasive surgery is a viable option

  • Montorsi F & al.
  • J Urol
  • 4 Nov 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • In patients with nonmetastatic muscle-invasive bladder cancer (MIBC), robot-assisted radical cystectomy (RARC) was associated with long-term oncologic outcomes, and recurrence rates and patterns were comparable to open radical cystectomy.
  • Advanced disease stage and positive surgical margins were associated with poor survival.

Why this matters

  • Long-term data on RARC outcomes are limited.

Study design

  • 446 consecutive patients (median age, 67 years) with nonmetastatic MIBC who underwent robot-assisted radical cystectomy 10 years ago or earlier.
  • Funding: Roswell Park Alliance Foundation; Vattikuti Foundation Collective Quality Initiative.

Key results

  • 10% of the patients received neoadjuvant chemotherapy, 51% experienced any complication, and 4% died within 90 days.
  • 43% of patients had ≥pT3 disease, 24% had pN+, and 7% had soft tissue surgical margin.
  • At a median follow-up of 5 years, 15% and 29% of patients developed local and distant recurrence, respectively.
  • 10-year recurrence-free survival (RFS), disease-specific survival (DSS), and OS rates were 59%, 65%, and 35%, respectively.
  • Pathological stage ≥T3 disease was associated with worse RFS, DSS, and OS (HR, 2.03, 4.05, and 2.69, respectively; all P<.01>
  • pN+ status was associated with poor RFS, DSS, and OS (HR, 2.17, 2.58, and 2.02, respectively; all P<.01>
  • Adjuvant treatment was associated with worse RFS (HR, 2.75; P<.01>

Limitations

  • Retrospective design.