Comparison of Laparoscopic and Open Radical Cystoprostatectomy for Localized Bladder Cancer With 3-Year Oncological Followup: A Single Surgeon Experience

Hemal, Ashok K.; Kolla, Surendra B.

doi:10.1016/j.juro.2007.08.020

Cited by 77 publications

(81 citation statements)

References 16 publications

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“…Other encouraging results were recently published by Snow-Lisy et al [8] in a cohort with the currently longest follow-up after minimally invasive RC, they reported OS and CSS rates of 48% and 71% at 5-years, and 35% and 63% at 10-years, compatible with our present findings. Furthermore, our present survival rates appear consistent with other mid-term reports after minimally invasive RC [27][28][29][30]. In particular Mmeje et al [30], in 50 patients with LN-positive disease after RARC, reported OS rates at 3 and 5 years of 55% and 45%, respectively.…”

Section: Long-term Oncological Outcome Of Lrcsupporting

confidence: 92%

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Long‐term analysis of oncological outcomes after laparoscopic radical cystectomy in Europe: results from a multicentre study by the European Association of Urology (EAU) section of Uro‐technology

et al. 2014

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ObjectiveTo report long-term outcomes of laparoscopic radical cystectomy (LRC) in a multicentre European cohort, and explore feasibility and safety of LRC. Patients and MethodsThis study was coordinated by European Association of Urology (EAU)-section of Uro-technology (ESUT) with nine centres enrolling 503 patients undergoing LRC for bladder cancer prospectively between 2000 and 2013. Data were retrospectively analysed. Descriptive statistics were used to explore peri-and postoperative characteristics of th ecohort. Kaplan-Meier curves were constructed to evaluate recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS). Outcomes were also stratified according to tumour stage, lymph node (LN) involvement and surgical margin status. ResultsMinor complications (Clavien I-II) occurred in 39% and major (IIIa-IVb) in 17%. In all, 10 (2%) postoperative deaths were recorded. The median (interquartile, IQR) LN retrieval was 14 (9-17) and positive surgical margins were detected in 29 (5.8%) patients. The median (mean, IQR) follow-up was 50 (60,, during which 134 (27%) recurrences were detected. Actuarial RFS, CSS and OS rates were 66%, 75% and 62% at 5 years and 62%, 55%, 38% at 10 years. Significant differences in RFS, CSS and OS were found according to tumour stage, LN involvement and margin status (log-rank P < 0.001). On multivariate Cox analysis, T stage and LN involvement (both P < 0.001) were significant predictors of RFS, CSS and OS. Positive margins were significant predictors of RFS (P = 0.016) and CSS (P = 0.043). ConclusionsIn this European LRC multicentre study, the largest to date, long-term RFS, CSS and OS rates after LRC appear comparable to those reported in current open RC series. Further randomised controlled trials are necessary to assess the global impact of LRC.

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Section: Long-term Oncological Outcome Of Lrcsupporting

confidence: 92%

“…which probably accounts for their lower RFS rate. Our present results are also [8,9,27]. Huang et al [9] in 171 patients undergoing LRC in China reported a 5-year RFS rate of 72.6%.…”

Section: Long-term Oncological Outcome Of Lrcsupporting

confidence: 79%

Long‐term analysis of oncological outcomes after laparoscopic radical cystectomy in Europe: results from a multicentre study by the European Association of Urology (EAU) section of Uro‐technology

et al. 2014

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“…Through different types of urinary diversion, the feasibility and safety of laparoscopic RC (LRC) has been demonstrated by several urologists (6 -8). However, LRC is associated with prolonged operative time and the real advantage of LRC over open RC (ORC) is not yet known because the data on comparison of LRC with ORC on a prospective basis are not sufficient-only two comparative studies published to date (9,10).…”

Section: Introductionmentioning

confidence: 99%

Robotic Versus Open Radical Cystectomy: Prospective Comparison of Perioperative and Pathologic Outcomes in Japan

Gondo

Yoshioka

Nakagami

et al. 2012

Japanese Journal of Clinical Oncology

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Objective: In Japan, no study has compared the perioperative outcomes observed between robot-assisted radical cystectomy (RARC) and open radical cystectomy (ORC). This study aimed at a prospective comparison of the perioperative outcomes between RARC and ORC performed by a single surgeon. Methods: Between 2008 and 2011, 26 bladder cancer patients underwent radical cystectomy by one surgeon, 11 robotically and 15 by open procedure. We prospectively collected perioperative and pathological data for these 26 patients, and retrospectively compared these two different surgical procedures. Results: The RARC cohort had a significant decrease in both estimated blood loss (656.9 vs. 1788.7 ml, P ¼ 0.0015) and allogeneic transfusion requirement (0 vs. 40%, P ¼ 0.0237). The total operative time was almost the same (P ¼ 0.2306) but increased duration of bladder removal and lymphadenectomy was observed in the RARC cohort (P ¼ 0.0049). Surgeryrelated complication rates within 30 days were not significantly different (P ¼ 0.4185). Positive surgical margin was observed in three patients in the ORC cohort and in one patient in the RARC cohort (P ¼ 0.4664). The RARC cohort had a larger number of removed lymph nodes than the ORC cohort, and the difference was statistically significant (20.7 vs. 13.8, P ¼ 0.0421). Conclusions: We confirmed that RARC is safe and yields acceptable outcomes in comparison with ORC for the treatment of bladder cancer if it is performed by a surgeon who has experience of over 60 cases of robot-assisted radical prostatectomy. It is hoped that RARC will gain acceptance in Japan as a minimally invasive surgery for muscle-invasive bladder cancer.

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“…A summary of the oncological and perioperative outcomes of the largest LRC series is presented in Table 2 [30,[32][33][34][35][36][37][38][39][40][41], with that of ORC from recognized centres of excellence [1,2,[4][5][6]21]. These LRC series are based on relatively few patients with a shortterm follow-up, and are representative of the early experience.…”

Section: Lrc: Initial Resultsmentioning

confidence: 99%

Laparoscopic radical cystectomy for muscle‐invasive bladder cancer: pathological and oncological outcomes

Stephenson

Gill

2008

BJU International

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morbidity and quicker convalescence, while maintaining oncological efficacy by recapitulating the open technique. We and others have investigated this procedure in selected patients with invasive bladder cancer, with slow and measured progress.We favour an open-assisted approach, performing the urinary diversion through a small midline incision. Preliminary comparative data suggest that openassisted LRC is associated with reduced blood loss and transfusion requirements and it might improve convalescence. These results are achieved while being comparable with ORC for postoperative complications, positive soft-tissue margin rates, and lymph node counts. This procedure is difficult to learn, and ideally it should be restricted to patients with clinically organ-confined cancers, and carried out by surgeons with extensive experience in pelvic laparoscopic procedures. Randomized trials are necessary to determine if the results achieved with LRC are equivalent to those of ORC.

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Comparison of Laparoscopic and Open Radical Cystoprostatectomy for Localized Bladder Cancer With 3-Year Oncological Followup: A Single Surgeon Experience

Cited by 77 publications

References 16 publications

Long‐term analysis of oncological outcomes after laparoscopic radical cystectomy in Europe: results from a multicentre study by the European Association of Urology (EAU) section of Uro‐technology

Long‐term analysis of oncological outcomes after laparoscopic radical cystectomy in Europe: results from a multicentre study by the European Association of Urology (EAU) section of Uro‐technology

Robotic Versus Open Radical Cystectomy: Prospective Comparison of Perioperative and Pathologic Outcomes in Japan

Laparoscopic radical cystectomy for muscle‐invasive bladder cancer: pathological and oncological outcomes

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