Journal article
Efficacy of robot‐assisted radical cystectomy (RARC) in advanced bladder cancer: results from the International Radical Cystectomy Consortium (IRCC)
BJU international, Vol.114(1), pp.98-103
07/2014
DOI: 10.1111/bju.12569
PMCID: PMC4196689
PMID: 24219170
Abstract
Objective
To characterise the surgical feasibility and outcomes of robot‐assisted radical cystectomy (RARC) for pathological T4 bladder cancer.
Patients and Methods
Retrospective evaluation of a prospectively maintained International Radical Cystectomy Consortium database was conducted for 1118 patients who underwent RARC between 2003 and 2012.
We dichotomised patients based on pathological stage (≤pT3 vs pT4) and evaluated demographic, operative and pathological variables in relation to morbidity and mortality.
Results
In all, 1000 ≤pT3 and 118 pT4 patients were evaluated. The pT4 patients were older than the ≤pT3 patients (P = 0.001).
The median operating time and blood loss were 386 min and 350 mL vs 396 min and 350 mL for p T4 and ≤pT3, respectively. The complication rate was similar (54% vs 58%; P = 0.64) among ≤pT3 and pT4 patients, respectively. The overall 30‐ and 90‐day mortality rate was 0.4% and 1.8% vs 4.2% and 8.5% for ≤pT3 vs pT4 patients (P < 0.001), respectively.
The body mass index (BMI), American Society of Anesthesiology score, length of hospital stay (LOS) >10 days, and 90‐day readmission were significantly associated with complications in pT4 patients.
Meanwhile, BMI, LOS >10 days, grade 3–5 complications, 90‐day readmission, smoking, previous abdominal surgery and neoadjuvant chemotherapy were significantly associated with mortality in pT4 patients. On multivariate analysis, BMI was an independent predictor of complications in pT4 patients, but not for mortality.
Conclusions
RARC for pT4 bladder cancer is surgically feasible but entails significant morbidity and mortality.
BMI was independent predictor of complications in pT4 patients.
Details
- Title: Subtitle
- Efficacy of robot‐assisted radical cystectomy (RARC) in advanced bladder cancer: results from the International Radical Cystectomy Consortium (IRCC)
- Creators
- Ali Al‐Daghmin - Roswell Park Cancer InstituteEric C Kauffman - Roswell Park Cancer InstituteYi Shi - Roswell Park Cancer InstituteKetan Badani - Columbia University Medical CenterM. Derya Balbay - Memorial Sisli HospitalErdem CandaProkar Dasgupta - Guy's HospitalReza Ghavamian - UN Hospital Albert Einstein College of MedicineRobert Grubb - Washington University School of MedicineAshok Hemal - Wake Forest University Baptist Medical CenterJihad Kaouk - Cleveland ClinicAdam S Kibel - Washington University School of MedicineThomas Maatman - Michigan Urological ClinicMani Menon - Henry Ford Health SystemAlex Mottrie - Onze‐Lieve‐Vrouw ZiekenhuisKenneth Nepple - Washington University School of MedicineJohn G Pattaras - Emory University School of MedicineJames O Peabody - Henry Ford Health SystemVassilis Poulakis - Doctor's Hospital of AthensRaj Pruthi - University of North CarolinaJuan Palou Redorta - Fundacio PuigvertKoon‐Ho Rha - Yonsei University Health Systems Severance HospitalLee Richstone - Arthur Smith Institute for UrologyFrancis Schanne - Urologic Surgical Associates of DelawareDouglas S Scherr - Samsung Medical CollegeStefan Siemer - University Clinics of SaarlandMichael Stöckle - University Clinics of SaarlandEric M Wallen - University of North CarolinaAlon Weizer - University of Michigan Health SystemPeter Wiklund - Karolinska University HospitalTimothy Wilson - City of Hope and Beckman Research InstituteGregory Wilding - Roswell Park Cancer InstituteMichael Woods - Loyola University Medical CenterKhurshid A Guru - Roswell Park Cancer Institute
- Resource Type
- Journal article
- Publication Details
- BJU international, Vol.114(1), pp.98-103
- DOI
- 10.1111/bju.12569
- PMID
- 24219170
- PMCID
- PMC4196689
- ISSN
- 1464-4096
- eISSN
- 1464-410X
- Number of pages
- 6
- Language
- English
- Date published
- 07/2014
- Academic Unit
- Urology
- Record Identifier
- 9984051899202771
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