- 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.
- 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.
- 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>
- Retrospective design.