Intermediate-term oncologic outcomes of robot-assisted radical cystectomy for urothelial carcinoma.
| Autor: | Yuh B; 1 Department of Urologic Oncology, City of Hope Comprehensive Cancer Center , Duarte, California., Torrey RR, Ruel NH, Wittig K, Tobis S, Linehan J, Lau CS, Chan KG, Yamzon J, Wilson TG |
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| Jazyk: | angličtina |
| Zdroj: | Journal of endourology [J Endourol] 2014 Aug; Vol. 28 (8), pp. 939-45. Date of Electronic Publication: 2014 Apr 16. |
| DOI: | 10.1089/end.2014.0073 |
| Abstrakt: | Purpose: To evaluate intermediate-term oncologic outcomes in a large series of patients who were treated with robot-assisted radical cystectomy (RARC) for urothelial carcinoma of the bladder (UCB). Patients and Methods: Between 2004 and 2010, 162 patients underwent RARC at City of Hope Cancer Center for UCB and were analyzed with respect to overall (OS), disease-specific (DSS), and disease-free survival (DFS). Descriptive statistics were used to summarize demographics and perioperative variables. The Kaplan-Meier method was used to estimate survival and recurrence. Univariable and multivariable Cox proportional hazards regression models were used to determine predictors of survival. Results: Median follow-up was 52 months. Thirty-eight (23.4%) patients received neoadjuvant chemotherapy before RARC; 28% of patients were pT2 and 33% had final pathology status of pT3 or pT4. Median lymph node count was 28, and positive surgical margin rate was 4.3%. Local recurrence occurred in 11 (6.8%) patients. OS, DFS, and DSS at 3 years were 61%, 76%, and 83%, respectively. OS, DFS, and DSS at 5 years were 54%, 74%, and 80%, respectively. Predictors of OS and DFS on multivariable analysis were lymph node density, pathologic stage, and age-adjusted Charlson Comorbidity Index, while receipt of transfusion was also a negative predictor of OS. Conclusions: RARC provides an effective means of treatment of UCB in a minimally invasive fashion with comparable oncologic outcomes to that reported in the literature of open procedures. |
| Databáze: | MEDLINE |
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