TY - JOUR
T1 - Open versus Robot-Assisted Radical Cystectomy for the Treatment of pT4a Bladder Cancer
T2 - Comparison of Perioperative Outcomes
AU - Perri, Davide
AU - Rocco, Bernardo
AU - Sighinolfi, Maria Chiara
AU - Bove, Pierluigi
AU - Pastore, Antonio L.
AU - Volpe, Alessandro
AU - Minervini, Andrea
AU - Antonelli, Alessandro
AU - Zaramella, Stefano
AU - Galfano, Antonio
AU - Cacciamani, Giovanni E.
AU - Celia, Antonio
AU - Dalpiaz, Orietta
AU - Crivellaro, Simone
AU - Greco, Francesco
AU - Pini, Giovannalberto
AU - Porreca, Angelo
AU - Pacchetti, Andrea
AU - Calcagnile, Tommaso
AU - Berti, Lorenzo
AU - Buizza, Carlo
AU - Mazzoleni, Federica
AU - Bozzini, Giorgio
N1 - Publisher Copyright:
© 2024 by the authors.
PY - 2024/4
Y1 - 2024/4
N2 - 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.
AB - 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.
KW - bladder cancer
KW - open radical cystectomy
KW - pT4
KW - robot-assisted radical cystectomy
UR - http://www.scopus.com/inward/record.url?scp=85190142721&partnerID=8YFLogxK
U2 - 10.3390/cancers16071329
DO - 10.3390/cancers16071329
M3 - Article
SN - 2072-6694
VL - 16
JO - Cancers
JF - Cancers
IS - 7
M1 - 1329
ER -
