The aim of our study was to assess the oncologic outcomes of robot-assisted radical cystectomy (RARC) in patients with bladder cancer (BCa) treated in a high-volume robotic center.
We retrospectively collected data of 155 consecutive patients who received RARC for urothelial BCa from January 2004 to May 2014.
Kaplan-Meier analyses were used to assess time to recurrence, cancer-specific mortality (CSM) rate, and overall mortality rate. Uni- and multivariable Cox regression models addressed the predictors of recurrence and CSM.
Median follow-up for survivors was 42 months. Overall, 43%, 34%, 55%, and 18% of the patients had pT ā¤1, pT2, pT3/4, and pN1-3 disease, respectively. Overall, 76% of the patients had high-grade disease at final pathology. The positive surgical margin rate was 9%. The 5-year recurrence-free, CSM-free, and overall survival estimates were 53. 7%, 73. 5%, and 65. 2%, respectively. Among patients who experienced recurrence, 12. 0%, 4. 0%, and 84. 0% had local, peritoneal, and distant recurrence, respectively. In multivariable Cox regression analyses, pathologic stage and nodal status represented independent predictors of recurrence and CSM (all pāā¤ā0. 04).
In a high-volume robotic center, RARC provides acceptable oncologic outcomes in patients with urothelial BCa. Tumor stage and nodal status represent independent predictors of recurrence and CSM in this setting.
Journal of endourology / Endourological Society. 2015 Sep 24 [Epub ahead of print]
Giorgio Gandaglia, Ruben De Groote, Nicolas Geurts, Frederiek D'Hondt, Francesco Montorsi, Giacomo Novara, Alexandre Mottrie
1 OLV Vattikuti Robotic Surgery Institute , Melle, Belgium . , 3 Department of Urology, Onze-Lieve-Vrouw Hospital , Aalst, Belgium . , 3 Department of Urology, Onze-Lieve-Vrouw Hospital , Aalst, Belgium . , 3 Department of Urology, Onze-Lieve-Vrouw Hospital , Aalst, Belgium . , 2 Unit of Urology, Division of Oncology, URI, IRCCS Ospedale San Raffaele , Milan, Italy . , 1 OLV Vattikuti Robotic Surgery Institute , Melle, Belgium . , 1 OLV Vattikuti Robotic Surgery Institute , Melle, Belgium .