Open and robotic-assisted radical cystectomy for muscle-invasive and high-risk nonmuscle-invasive bladder cancer are associated with similar intermediate-term overall and recurrence-free survival, according to study findings presented at the 36th European Association of Urology congress.

Investigators in The Netherlands compared the surgical approaches in 1472 patients, of whom 1086 underwent open radical cystectomy (ORC) and 386 underwent robotic-assisted radical cystectomy (RARC). Investigators did not select patients based on hospital or surgical volume or patient characteristics. “Therefore, the study was really a reflection of clinical practice,” said investigator Sytse van Beek, MD, of Erasmus Medical Center in Rotterdam, who reported study findings in an oral presentation.

The median overall survival (OS) was 5.0 years for ORC and 5.7 years for RARC, Dr Beek reported. The median recurrence-free survival was 3.7 years for ORC and 4.9 years for RARC. After adjusting for multiple variables, the surgical approaches did not differ significantly with respect to these outcomes.

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The ORC group was older than the RARC group (median 69 vs 67 years), had a higher serum creatinine level (median 90 vs 85 µmol/L), and included a higher proportion of patients with more advanced clinical and pathological disease stage, which, according to the investigators, reflects selection of patients with more favorable prognostic factors for RARC in clinical practice.


Hinsenveld FJ, Boorsmans JL, der Poel V, et al. Intermediate-term overall survival of robotic-assisted versus open radical cystectomy for muscle-invasive and high-risk nonmuscle-invasive bladder cancer in the Netherlands. Presented at: EAU 2021, July 8-12, 2021. Abstract P0823.