For patients with bladder cancer undergoing radical cystectomy, a robotic approach seems to have the same oncologic efficacy as an open approach and demonstrates potential perioperative benefits, according to a pilot study published online The Journal of Urology.
Dipen J. Parekh, MD, from the University of Texas Health Sciences Center at San Antonio, and colleagues conducted a prospective randomized trial comparing the perioperative outcomes and oncologic efficacy of open and robotic assisted laparoscopic radical cystectomy. Data were available for 40 patients.
The researchers observed no significant differences between the groups with respect to the oncologic outcomes of positive margins (5% each) or the number of lymph nodes removed (23 for open radical cystectomy vs. 11 for robotic assisted laparoscopic radical cystectomy. The estimated blood loss was reduced for the robotic assisted laparoscopic radical cystectomy group (400 mL) compared with the open radical cystectomy group (800 mL). In addition, the study revealed a decreased rate of stays longer than five days in the robotic group (65% vs. 90%) as well as a trend toward fewer transfusions (40% vs. 50%), but the differences were not statistically significant.
“Our results suggest no significant differences in surrogates of oncologic efficacy,” the investigators wrote. “Robotic assisted laparoscopic radical cystectomy demonstrates potential benefits of decreased estimated blood loss and decreased hospital stay compared to open radical cystectomy. Our results need to be validated in a larger multicenter prospective randomized clinical trial.”