Anatomic Robot-Assisted Radical Cystectomy in Male

Peak, Taylor C.; Hemal, Ashok K.

doi:10.1007/978-3-319-20645-5_52

Cited by 2 publications

(2 citation statements)

References 46 publications

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“…The specimen is then immediately placed in the specimen bag for later removal. The bladder defect is closed in 2 layers with barbed suture and a bilateral pelvic lymphadenectomy is performed (22).…”

Section: Robotic Pcmentioning

confidence: 99%

Partial cystectomy for muscle-invasive bladder cancer: a review of the literature

Peak¹,

Hemal²

2020

Transl Androl Urol

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The radical cystectomy (RC) for muscle-invasive bladder cancer is one of the most morbid and complex urologic procedures performed today. To avoid these complications, the partial cystectomy (PC) has been offered as an alternative in carefully selected patients as a means of achieving equal oncologic efficacy with less morbidity. Selection criteria should include solitary tumors without concomitant carcinoma in situ (CIS) and amenable to resection with 1-2 cm margins in a normally functioning bladder. In addition to the standard work-up, random bladder and prostatic biopsies may be performed. The PC can be performed through an open, laparoscopic, or robot-assisted approach, each with acceptable outcomes. A number of techniques have been developed to identify and resect the tumor completely with negative margins, while preventing tumor spillage within the abdomen. While there are no randomized trials, single institution series have demonstrated acceptable oncologic outcomes in appropriately selected patients. Therefore, offering PC in the appropriate candidate, including those patients who do not accept or are unfit for the associated morbidity of a RC, represents an acceptable alternative.

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Section: Robotic Pcmentioning

confidence: 99%

Partial cystectomy for muscle-invasive bladder cancer: a review of the literature

Peak¹,

Hemal²

2020

Transl Androl Urol

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“…By using our radical cystectomy database, we have performed simultaneous analyses utilizing both the semi-competing risk model along with a standard survival model to determine factors that affect the complication rate and overall survival, specifically stratifying the extracorporeal and intracorporeal robot-assisted radical cystectomy (RARC) for comparison with open radical cystectomy (ORC). 15 These two models serve to highlight the fundamental differences in the statistical analyses, and demonstrate how a semi-competing risk model with a new insight brings us closer to understanding the effects of our therapeutic approaches.…”

Section: Introductionmentioning

confidence: 99%

Semi-competing risk model to predict perioperative and oncologic outcomes after radical cystectomy

Peak

Chapple

Coon

et al. 2018

Therapeutic Advances in Urology

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Background: To utilize a semi-competing risk model to predict perioperative and oncologic outcomes after radical cystectomy and to compare the findings with the univariate Cox regression model. Methods: We reviewed the Institutional Review Board approved database of radical cystectomy of 316 patients who had undergone robot-assisted radical cystectomy (RARC) or open radical cystectomy between 2006 and 2016. Demographic data, perioperative outcomes, complications, metastasis, and survival were analyzed. The Bayesian variable selection method was utilized to obtain models for each hazard function in the semi-competing risks. Results: Of 316 patients treated, 48% and 18% experienced any or major complication respectively within 30 days. Intracorporeal RARC was associated with decreased metastasis risk. Extracorporeal RARC was associated with marginally decreased risks of overall complications or major complications. Patients with advanced cancer had an increased risk of metastasis, death after metastasis and death after complication. Positive nodes were associated with an increased risk of death without overall or major complications and increased risk of death after metastasis occurs. When a serious complication was taken into account there was no significant difference in mortality, irrespective of disease stage. Conclusions: A semi-competing risk model provides relatively more accurate information in comparison to Cox regression analysis in predicting risk factors for complications and metastasis in patients undergoing radical cystectomy.

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Anatomic Robot-Assisted Radical Cystectomy in Male

Cited by 2 publications

References 46 publications

Partial cystectomy for muscle-invasive bladder cancer: a review of the literature

Partial cystectomy for muscle-invasive bladder cancer: a review of the literature

Semi-competing risk model to predict perioperative and oncologic outcomes after radical cystectomy

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