Erschienen in:
15.11.2022 | Letter to the Editor
Long-term oncologic outcomes of robot-assisted radical cystectomy: update series from a high-volume robotic center beyond 10 years of follow-up
verfasst von:
Carlo A. Bravi, Pietro Piazza, Elio Mazzone, Paolo Dell’Oglio, Giuseppe Rosiello, Alberto Martini, Armando Stabile, Marco Moschini, Marco Amato, Luca Sarchi, Maria Peraire, Rui Farinha, Simone Scarcella, Stefano Puliatti, Sophie Knipper, Camille Berquin, Dries Develtere, Celine Sinatti, Hannah Van Puyvelde, Ruben De Groote, Geert De Naeyer, Frederiek D’Hondt, Peter Schatteman, Alberto Briganti, Francesco Montorsi, Alexandre Mottrie
Erschienen in:
Journal of Robotic Surgery
|
Ausgabe 3/2023
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Abstract
Long-term oncologic data on patients undergoing robot-assisted radical cystectomy (RARC) for non-metastatic bladder cancer (BCa) are limited. The purpose of this study is to describe long-term oncologic outcomes of patients receiving robotic radical cystectomy at a high-volume European Institution. We analyzed data of 107 patients treated with RARC between 2003 and 2012 at a high-volume robotic center. Clinical, pathologic, and survival data at the latest follow-up were collected. Clinical recurrence (CR)-free survival, cancer-specific mortality (CSM)-free survival, and overall survival (OS) were plotted using Kaplan–Meier survival curves. Cox proportional hazard models investigated predictors of CR and CSM. Competing-risk regressions were utilized to depict cumulative incidences of death from BCa and death from other causes after RARC at long term. Pathologic nonorgan-confined BCa was found in 40% of patients, and 7 (7%) patients had positive soft tissue surgical margins. Median (interquartile range [IQR]) number of nodes removed was 11 (6, 14), and 26% of patients had pN + disease. Median (IQR) follow-up for survivors was 123 (117, 149) months. The 12-year CR-free, CSM-free and overall survival were 55% (95% confidence interval [CI] 44%, 65%), 62% (95% CI 50%, 72%), and 34% (95% CI 24%, 44%), respectively. Nodal involvement on final pathology was associated with poor prognosis on multivariable competing risk analysis. The cumulative incidence of non-cancer death exceeded that of death from BCa after approximately ten years after RARC. We provided relevant data on oncologic outcomes of RARC at a high-volume robotic center, with acceptable rates of clinical recurrence and cancer-specific survival at long-term. In patients treated with RARC, the cumulative incidence of death from causes other than BCa is non-negligible, and should be taken into consideration for post-operative follow-up.