OBJECTIVE: To report oncologic outcomes and complications after robotic-assisted radical cystectomy (RARC).
MATERIALS AND METHODS: From March 2004 to August 2011, 175 consecutive patients underwent RARC with extracorporeal urinary diversion at our institution by a single surgeon. The study design was prospective. Perioperative parameters and postoperative complications were prospectively collected using the modified Clavien system. Recurrence-free survival and cancer-specific survival curves were generated using the Kaplan-Meier method.
RESULTS: A total of 145 men and 30 women with a median age of 73 years and a median body mass index of 27 kg/m2 underwent RARC. Four patients (2.3%) required conversion to open surgery because of difficulty to progress. One hundred nine patients (62%) underwent a transcutaneous ileal conduit, 40 patients (23%) an orthotopic neobladder, and 26 (15%) a continent cutaneous conduit. The median operating time was 360 minutes (interquartile range [IQR]: 300-420). The median estimated blood loss was 400 mL (IQR: 250-612), with a transfusion rate of 17.0%. The median postoperative length of stay was 7.0 days (IQR: 5.2-10). Early (< 30 days) and late surgery-related complications (30-90 days) occurred in 74 (42%) and 59 (34%) patients, respectively. The perioperative mortality rate was 2.8%. The positive soft tissue surgical margins rate was 5%. The median number of lymph nodes removed was 19 (IQR: 12-28). The median follow-up was 37 months (IQR: 21.5-53.5). Actuarial recurrence-free survival and cancer-specific survival at 2, 3, and 5 years after RARC were 67%, 63%, 63% and 73%, 68%, 66%, respectively.
CONCLUSION: RARC achieved mid-term oncologic efficacy. Moreover, the complication rates were comparable with open radical cystectomy series.
Written by:
Xylinas E, Green DA, Otto B, Jamzadeh A, Kluth L, Lee RK, Robinson BD, Shariat SF, Scherr DS. Are you the author?
Department of Urology, Weill Cornell Medical College, New York, NY.
Reference: Urology. 2013 Dec;82(6):1323-9.
doi: 10.1016/j.urology.2013.07.048
PubMed Abstract
PMID: 24295248
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