TY - JOUR
T1 - Open versus robotic cystectomy
T2 - A propensity score matched analysis comparing survival outcomes
AU - Moschini, Marco
AU - Zamboni, Stefania
AU - Soria, Francesco
AU - Mathieu, Romain
AU - Xylinas, Evanguelos
AU - Shen Tan, Wei
AU - Kelly, John D.
AU - Simone, Giuseppe
AU - Meraney, Anoop
AU - Krishna, Suprita
AU - Konety, Badrinath
AU - Mattei, Agostino
AU - Baumeister, Philipp
AU - Mordasini, Livio
AU - Montorsi, Francesco
AU - Briganti, Alberto
AU - Gallina, Andrea
AU - Stabile, Armando
AU - Sanchez-Salas, Rafael
AU - Cathelineau, Xavier
AU - Rink, Michael
AU - Necchi, Andrea
AU - Karakiewicz, Pierre I.
AU - Rouprêt, Morgan
AU - Koupparis, Anthony
AU - Kassouf, Wassim
AU - Scherr, Douglas S.
AU - Ploussard, Guillaume
AU - Boorjian, Stephen A.
AU - Lotan, Yair
AU - Sooriakumaran, Prasanna
AU - Shariat, Shahrokh F.
N1 - Publisher Copyright:
© 2019 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2019/8
Y1 - 2019/8
N2 - Background: To assess the differential effect of robotic assisted radical cystectomy (RARC) versus open radical cystectomy (ORC) on survival outcomes in matched analyses performed on a large multicentric cohort. Methods: The study included 9757 patients with urothelial bladder cancer (BCa) treated in a consecutive manner at each of 25 institutions. All patients underwent radical cystectomy with bilateral pelvic lymphadenectomy. To adjust for potential selection bias, propensity score matching 2:1 was performed with two ORC patients matched to one RARC patient. The propensity-matched cohort included 1374 patients. Multivariable competing risk analyses accounting for death of other causes, tested association of surgical technique with recurrence and cancer specific mortality (CSM), before and after propensity score matching. Results: Overall, 767 (7.8%) patients underwent RARC and 8990 (92.2%) ORC. The median follow-up before and after propensity matching was 81 and 102 months, respectively. In the overall population, the 3-year recurrence rates and CSM were 37% vs. 26% and 34% vs. 24% for ORC vs. RARC (all p values > 0.1), respectively. On multivariable Cox regression analyses, RARC and ORC had similar recurrence and CSM rates before and after matching (all p values > 0.1). Conclusions: Patients treated with RARC and ORC have similar survival outcomes. This data is helpful in consulting patients until long term survival outcomes of level one evidence is available.
AB - Background: To assess the differential effect of robotic assisted radical cystectomy (RARC) versus open radical cystectomy (ORC) on survival outcomes in matched analyses performed on a large multicentric cohort. Methods: The study included 9757 patients with urothelial bladder cancer (BCa) treated in a consecutive manner at each of 25 institutions. All patients underwent radical cystectomy with bilateral pelvic lymphadenectomy. To adjust for potential selection bias, propensity score matching 2:1 was performed with two ORC patients matched to one RARC patient. The propensity-matched cohort included 1374 patients. Multivariable competing risk analyses accounting for death of other causes, tested association of surgical technique with recurrence and cancer specific mortality (CSM), before and after propensity score matching. Results: Overall, 767 (7.8%) patients underwent RARC and 8990 (92.2%) ORC. The median follow-up before and after propensity matching was 81 and 102 months, respectively. In the overall population, the 3-year recurrence rates and CSM were 37% vs. 26% and 34% vs. 24% for ORC vs. RARC (all p values > 0.1), respectively. On multivariable Cox regression analyses, RARC and ORC had similar recurrence and CSM rates before and after matching (all p values > 0.1). Conclusions: Patients treated with RARC and ORC have similar survival outcomes. This data is helpful in consulting patients until long term survival outcomes of level one evidence is available.
KW - Bladder cancer
KW - Open
KW - Propensity score
KW - Radical cystectomy
KW - Robotic-assisted
KW - Survival
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U2 - 10.3390/jcm8081192
DO - 10.3390/jcm8081192
M3 - Article
C2 - 31395826
AN - SCOPUS:85081720860
SN - 2077-0383
VL - 8
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 8
M1 - 1192
ER -