Background: Laparoscopic radical cystectomy (LRC) is increasingly being used for muscle-invasive bladder cancer.
However, high levels of clinical evidence comparing laparoscopic vs open radical cystectomy (ORC) are lacking.
Methods: A prospective randomised controlled clinical trial comparing LRC vs ORC in patients undergoing radical cystectomy for bladder cancer. Thirty-five patients were eligible for final analysis in each group.
Results: The median follow-up was 26 months (range, 4-59 months) for laparoscopic vs 32 months (range, 6-60 months) for ORC. Significant differences were noted in operative time, estimated blood loss (EBL), blood transfusion rate, analgesic requirement, and time to resumption of oral intake. No significant differences were noted in the length of hospital stay, complication rate, lymph node yield (14.1±6.3 for LRC and 15.2±5.9 for ORC), positive surgical margin rate, postoperative pathology, or recurrence rate (7 for LRC and 8 for ORC). The 5-year recurrence-free survival with laparoscopic vs ORC was 78.5% vs 70.9%, respectively (P=0.773). The overall survival with laparoscopic vs ORC was 73.8% vs 67.4%, respectively (P=0.511).
Conclusion: Our study demonstrated that LRC is superior to ORC in perioperative outcomes, including EBL, blood transfusion rate, and analgesic requirement. We found no major difference in oncologic outcomes. The number of patients is too small to allow for a final conclusion.
Written by:
Lin T, Fan X, Zhang C, Xu K, Liu H, Zhang J, Jiang C, Huang H, Han J, Yao Y, Xie W, Dong W, Bi L, Huang J. Are you the author?
1Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, China.
Reference: Br J Cancer. 2014 Feb 18;110(4):842-9.
doi: 10.1038/bjc.2013.777
PubMed Abstract
PMID: 24407192
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