Robotic-assisted radical cystectomy (RARC) and open radical cystectomy (ORC) for urothelial bladder cancer offer patients similar cancer-specific survival outcomes, according to a new study.
In a study of 9757 patients who underwent either procedure with bilateral lymphadenectomy, the 3-year recurrence rates were 26% and 37% for the RARC and ORC groups, respectively. The cancer-specific mortality (CSM) rates were 24% and 34%, respectively. None of the differences between the groups was statistically significant. On multivariate analysis, the groups had similar recurrence and CSM rates both before and after propensity score matching to adjust for potential selection bias, Marco Moschini, MD, of the Medical University of Vienna in Austria, and colleagues reported in the Journal of Clinical Medicine.
The study population included 767 patients (7.8%) who underwent RARC and 8990 (92.2%) who underwent ORC. The investigators propensity score matched 2 ORC patients to 1 RARC patient. The median follow-up before and after propensity score matching was 81 and 102 months, respectively.
Although the study included the largest available cohort to date examining survival outcomes among RARC patients, the authors noted, it had limitations. “First and foremost, we recognize that our study is limited by its observational nature, and thus our results should be interpreted within the limits of its retrospective design,” Dr Moschini and his collaborators pointed out. In addition, they noted that they did not perform a central review of all specimens and did not include data regarding urinary diversion that might have an influence on survival outcomes.
Moschini M, Zamboni S, Soria F, et al. Open versus robotic cystectomy: A propensity score matched analysis comparing survival outcomes. J Clin Med. 2019. doi: 10.3390/jcm8081192