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Oncologic outcomes between open and robotic-assisted radical cystectomy: a propensity score matched analysis

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Abstract

Purpose

To compare oncologic outcomes between open radical cystectomy (ORC) and robotic-assisted radical cystectomy (RARC) using propensity score (PS) matching of preoperative variables.

Methods

A group of 51 consecutive patients who underwent RARC between 2009 and 2012 were matched by propensity scoring with an equal number of patients who underwent ORC. Patient demographics, clinical staging, pathologic staging, pathologic grading, histology, positive margin status, lymph node yield, duration of hospital stay, and overall survival were examined.

Results

PS-matched ORC and RARC cohorts demonstrated no significant differences with respect to preoperative variables, pathologic stage, grade, histology, metastasis at preoperative staging, and postoperative positive margin status. There were statistically significant differences in nodal status (66.7 % N0 for ORC vs. 80.4 % N0 for RARC, p = 0.039) and median lymph node yield (6 for ORC vs. 18 for RARC, p < 0.0001). No positive soft tissue margins were observed in the RARC group compared to 5.9 % in the ORC group (p = 0.332). There were no significant differences in mean duration of hospital stay or mean overall survival between ORC and RARC.

Conclusion

ORC and RARC represent effective surgical approaches for the treatment of bladder cancer. Histopathologic outcomes for RARC compare favorably to ORC with respect to soft tissue margin rates and lymph node yield. These data suggest that RARC is an acceptable surgical approach for treatment of bladder cancer that can achieve outcomes that are equal or superior to those of ORC.

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Conflict of interest

A Charles Huggins-Grant of the German Society of Urology funded Dr. Busch. Dr. Gonzalgo has served as a consultant to Intuitive Surgical, Inc. There are no additional disclosures.

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Authors and Affiliations

  1. Department of Urology, Stanford University School of Medicine, Stanford, CA, USA

    Michael Ahdoot, Leanne Almario, Hiwot Araya & Simon Conti

  2. Department of Urology, Charité University Medicine Berlin, Berlin, Germany

    Jonas Busch

  3. Department of Urology, University of Miami Miller School of Medicine, Miami, FL, 33136, USA

    Mark L. Gonzalgo

Authors
  1. Michael Ahdoot
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  2. Leanne Almario
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  3. Hiwot Araya
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  4. Jonas Busch
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  5. Simon Conti
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  6. Mark L. Gonzalgo
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Correspondence to Mark L. Gonzalgo.

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Ahdoot, M., Almario, L., Araya, H. et al. Oncologic outcomes between open and robotic-assisted radical cystectomy: a propensity score matched analysis. World J Urol 32, 1441–1446 (2014). https://doi.org/10.1007/s00345-014-1242-4

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  • DOI: https://doi.org/10.1007/s00345-014-1242-4

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