학술논문
Open versus Robot-Assisted Radical Cystectomy for the Treatment of pT4a Bladder Cancer: Comparison of Perioperative Outcomes
Document Type
article
Author
Davide Perri; Bernardo Rocco; Maria Chiara Sighinolfi; Pierluigi Bove; Antonio L. Pastore; Alessandro Volpe; Andrea Minervini; Alessandro Antonelli; Stefano Zaramella; Antonio Galfano; Giovanni E. Cacciamani; Antonio Celia; Orietta Dalpiaz; Simone Crivellaro; Francesco Greco; Giovannalberto Pini; Angelo Porreca; Andrea Pacchetti; Tommaso Calcagnile; Lorenzo Berti; Carlo Buizza; Federica Mazzoleni; Giorgio Bozzini
Source
Cancers, Vol 16, Iss 7, p 1329 (2024)
Subject
Language
English
ISSN
2072-6694
Abstract
We compared the perioperative outcomes of open (ORC) vs. robot-assisted (RARC) radical cystectomy in the treatment of pT4a MIBC. In total, 212 patients underwent ORC (102 patients, Group A) vs. RARC (110 patients, Group B) for pT4a bladder cancer. Patients were prospectively followed and retrospectively reviewed. We assessed operative time, estimated blood loss (EBL), intraoperative and postoperative complications, length of stay, transfusion rate, and oncological outcomes. Preoperative features were comparable. The mean operative time was 232.8 vs. 189.2 min (p = 0.04), and mean EBL was 832.8 vs. 523.7 mL in Group A vs. B (p = 0.04). An intraoperative transfusion was performed in 32 (31.4%) vs. 11 (10.0%) cases during ORC vs. RARC (p = 0.03). The intraoperative complications rate was comparable. The mean length of stay was shorter after RARC (12.6 vs. 7.2 days, p = 0.02). Postoperative transfusions were performed in 36 (35.3%) vs. 13 (11.8%) cases (p = 0.03), and postoperative complications occurred in 37 (36.3%) vs. 29 (26.4%) patients in Groups A vs. B (p = 0.05). The positive surgical margin (PSM) rate was lower after RARC. No differences were recorded according to the oncological outcomes. ORC and RARC are feasible treatments for the management of pT4a bladder tumors. Minimally invasive surgery provides shorter operative time, bleeding, transfusion rate, postoperative complications, length of stay, and PSM rate.