Perioperative and mid-term oncologic outcomes of robotic assisted radical cystectomy with totally intracorporeal neobladder: Results of a propensity score matched comparison with open cohort from a single-centre series

Simone, Giuseppe; Tuderti, Gabriele; Misuraca, Leonardo; Anceschi, Umberto; Ferriero, Mariaconsiglia; Minisola, Francesco; Guaglianone, Salvatore; Gallucci, Michele

doi:10.1016/j.ejso.2018.04.006

Cited by 62 publications

(57 citation statements)

References 20 publications

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“…43 Table 1 shows a summary of the RFS, CSS and overall studies. [44][45][46][47][48][49][50][51][52][53][54][55][56][57] The RFS after ORC was affected by the stage of disease, with a 75%, 60% and 30% long-term disease control rate for organ-confined, extravesical and LN-positive disease, respectively. 45 Mmeje et al showed that the use of any chemotherapy resulted in a significant improvement in OS, with 68% of patients at 36 months as compared with 36% of patients who did not receive any chemotherapy, among a total of 275 patients who underwent RARC.…”

Section: Oncological Outcomes and Comparison With Orc Or Lrcmentioning

confidence: 99%

“…48 Comparison of ORC oncological outcomes of RARC were similar in controlled, propensity-matched and randomized controlled studies. 51,55,56,[58][59][60][61][62][63] RARC has less overall perioperative complications, greater LNYs, less EBL, less need for perioperative transfusion and a shorter LOS; however, these studies are not sufficient to determine differences in cancer recurrence, and further clinical studies are required in the future. Only one study has shown a benefit of OS for patients receiving RARC.…”

Section: Oncological Outcomes and Comparison With Orc Or Lrcmentioning

confidence: 99%

“…68 The follow-up period was similar for both ORC and RARC. During the follow-up period, 99 patients (ORC, 44 Martin, 2009 45 Huang, 2010 46 Mmeje, 2013 48 Snow-Lisy, 2014 49 Raza, 2014 51 Al-Daghmin, 2014 53 Gandaglia, 2016 54 Bochner, 2018 55 Simone, 2018 56 Hanna, 2018 62 Parekh, 2018 63 Procedure 69 Chronic kidney diseases and perioperative blood transfusion were associated with a higher risk of distant or atypical recurrence, but not of local recurrence. It was discussed that decreased renal function might be indicative of an immunosuppressed milieu, impaired DNA repair and nutritional deficiencies.…”

Section: Recurrence Patternmentioning

confidence: 99%

“…Investigations of mid‐ and long‐term oncological outcomes have been compiled . Table shows a summary of the RFS, CSS and overall studies . The RFS after ORC was affected by the stage of disease, with a 75%, 60% and 30% long‐term disease control rate for organ‐confined, extravesical and LN‐positive disease, respectively .…”

Section: Introductionmentioning

confidence: 99%

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Current status and future perspective of robot‐assisted radical cystectomy for invasive bladder cancer

Fujimura

2019

Int J of Urology

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The current status of robot‐assisted radical cystectomy was reviewed 16 years after the initial robot‐assisted radical cystectomy for the treatment of invasive bladder cancer. Articles associated with robot‐assisted radical cystectomy and written in English were selected from the PubMed database from January 2003 to February 2019. The present review article focused on the distribution of robot‐assisted radical cystectomy, patient selection, preoperative management, surgical technique, lymph node dissection, urinary diversion, recurrence pattern, oncological outcomes, cost, learning curve, complications and educational programs. A total of 400 articles were divided according to the country of the first author's affiliation. The USA was the most dominant at 198 (50%), whereas the number of articles from the countries belonging to the Urological Association of Asia was 15 (3.8%) for China, 17 (4.3%) for South Korea, 10 (2.5%) for Japan, eight (2%) for Taiwan, eight (2%) for Turkey and one (0.2%) for Iran. The percentage of robot‐assisted radical cystectomy carried out is increasing, and intracorporeal urinary diversion and ileal neobladder are also frequently carried out. With a refined technique being performed in high‐volume centers, robot‐assisted radical cystectomy has contributed to the reduction in transfusion rate, length of stay and severe complications; however, it has not yet shown any cancer‐specific survival benefits. Robot‐assisted radical cystectomy is not fully spread throughout the Urological Association of Asia. Further investigation with respect to worldwide results is needed to prove the real benefit of robot‐assisted radical cystectomy regarding low morbidity, reduced total medical cost, and survival benefit. In the era of precision medicine, appropriate drug and surgery will be given based on each genetic profile.

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Section: Oncological Outcomes and Comparison With Orc Or Lrcmentioning

confidence: 99%

Section: Oncological Outcomes and Comparison With Orc Or Lrcmentioning

confidence: 99%

Section: Recurrence Patternmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Current status and future perspective of robot‐assisted radical cystectomy for invasive bladder cancer

Fujimura

2019

Int J of Urology

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“…36,37 On review of the literature, we identified 10 studies with RARC followed by ICUD (Table 2). 13,14,26,[38][39][40][41][42][43][44] The IRCC study retrospectively compared the perioperative outcomes in 935 patients undergoing ICUD (n = 167) and ECUD (n = 768) followed by RARC. 37 Although there were no statistically significant differences in the 90-day complication rates, the ICUD group tended to have fewer overall complications (P = 0.059), significantly fewer gastrointestinal complications (P < 0.001) and lower transfusion rates (P = 0.02).…”

Section: Icud After Rarcmentioning

confidence: 99%

Utility of robot‐assisted radical cystectomy with intracorporeal urinary diversion for muscle‐invasive bladder cancer

et al. 2019

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Radical cystectomy remains the gold standard for treatment of muscle‐invasive bladder cancer. Robot‐assisted radical cystectomy has technical advantages over laparoscopic radical cystectomy and has emerged as an alternative to open radical cystectomy. Despite the advancements in robotic surgery, experience with total intracorporeal reconstruction of urinary diversion remains limited. Most surgeons have carried out the hybrid approach of robot‐assisted radical cystectomy and extracorporeal reconstruction of urinary diversion, as intracorporeal reconstruction of urinary diversion remains technically challenging. However, intracorporeal reconstruction of urinary diversion might potentially proffer additional benefits, such as decreased fluid loss, reduction in estimated blood loss and a quicker return of bowel function. The adoption of intracorporeal ileal neobladder reconstruction has hitherto been limited to high‐volume academic institutions. In the present review, we compare the totally intracorporeal robot‐assisted radical cystectomy approach with open radical cystectomy and robot‐assisted radical cystectomy + extracorporeal reconstruction of urinary diversion in muscle‐invasive bladder cancer patients.

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The CUSUM curve combined with comprehensive complication index for assessing short‐term complications of radical cystectomy

Zhou

Gao

Liao

et al. 2022

Clinical Laboratory Analysis

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Objective To evaluate the comprehensive complication index(CCI) and Clavien‐Dindo classification(CDC) for short‐term postoperative complications in radical cystectomy and assess cumulative surgical morbidity to compare sufficient surgical skill. Methods From September 30, 2010, to October 1, 2020, clinical data of patients with urothelial carcinoma who underwent radical cystectomy with urinary diversion were gathered, patients who had only a urinary diversion, bladder sparing surgery, additional abdominal surgeries at the same time were all excluded. The CDC and CCI were utilized to evaluate 30‐d complications after radical cystectomy and the relevance of hospital stay was compared between CCI and CDC. The cumulative sum control models (CUSUM) were used to evaluate the overall surgical morbidity of radical cystectomy in our facility and for comparisons between surgeons. Results This study enrolled a total of 635 individuals, 548 (86.3%) of whom had 1124 problems. The incidence of severe complications (CDC≥ Grade III) was 10.2%. The average CCI was 20.2 ± 14.7. Gender, urinary diversion subtype, procedure method, and surgeon were significantly correlated with the increase of CCI ( p < 0.05). The CCI demonstrated a better relationship with hospital stay ( R 2 = 0.429) than the CDC (R 2 = 0.361). The CUSUM‐CCI model demonstrated a difference and growth distribution in dynamic time between individual surgeons. Conclusions CCI can better reflect the incidence of complications for radical cystectomy than CDC, and CCI is more strongly correlated with postoperative hospital stay. The CUSUM‐CCI model can reflect the quality of surgical skill for each surgeon instantaneously.

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Perioperative and mid-term oncologic outcomes of robotic assisted radical cystectomy with totally intracorporeal neobladder: Results of a propensity score matched comparison with open cohort from a single-centre series

Cited by 62 publications

References 20 publications

Current status and future perspective of robot‐assisted radical cystectomy for invasive bladder cancer

Current status and future perspective of robot‐assisted radical cystectomy for invasive bladder cancer

Utility of robot‐assisted radical cystectomy with intracorporeal urinary diversion for muscle‐invasive bladder cancer

The CUSUM curve combined with comprehensive complication index for assessing short‐term complications of radical cystectomy

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