Intermediate-term survival of robot-assisted versus open radical cystectomy for muscle-invasive and high-risk non-muscle invasive bladder cancer in The Netherlands.

Autor: Hinsenveld FJ; Department of Urology, Amsterdam University Medical Centres location Vrije University Medical Centre, Amsterdam, The Netherlands., Boormans JL; Department of Urology, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: j.boormans@erasmusmc.nl., van der Poel HG; Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands., van der Schoot DKE; Department of Urology, Amphia Hospital, Breda, The Netherlands., Vis AN; Department of Urology, Amsterdam University Medical Centres location Vrije University Medical Centre, Amsterdam, The Netherlands., Aben KKH; Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands; Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands., Arends TJ; Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands., Ausems PJ; Department of Urology, HagaZiekenuis, Den Haag, The Netherlands., Baselmans D; Department of Urology, Máxima Medical Centre, Veldhoven, The Netherlands., Berger C; Department of Urology, Haaglanden Medical Centre, Den Haag, The Netherlands., Berrens A; Department of Urology, Franciscus Hospital, Rotterdam, The Netherlands., Bickerstaffe H; Department of Urology, Bravis Hospital, Bergen op Zoom, Roosendaal, The Netherlands., Bos SD; Department of Urology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands., Braam M; Department of Urology, Martini Hospital, Groningen, The Netherlands., Buddingh KT; Department of Urology, HagaZiekenuis, Den Haag, The Netherlands., Claus S; Department of Urology, Catharina Hospital, Eindhoven, The Netherlands., Dekker K; Department of Urology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands., van Doeveren T; Department of Urology, Erasmus Medical Centre, Rotterdam, The Netherlands., Einerhand S; Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Fossion L; Department of Urology, Máxima Medical Centre, Veldhoven, The Netherlands., van Gennep EJ; Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands., van Ginkel N; Department of Urology, Spaarne Gasthuis, Haarlem, Hoofddorp, The Netherlands., Palacios G; Department of Urology, Haaglanden Medical Centre, Den Haag, The Netherlands., Hermans T; Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands., Hobijn MM; Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands., van Huystee SH; Department of Urology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands., Jaspers-Valentijn M; Department of Urology, Bravis Hospital, Bergen op Zoom, Roosendaal, The Netherlands., Klaver OS; Department of Urology, Maasstad Hospital, Rotterdam, The Netherlands., Koldewijn EL; Department of Urology, Catharina Hospital, Eindhoven, The Netherlands., Korsten L; Department of Urology, Elisabeth TweeSteden Hospital, Tilburg, The Netherland., Lenting A; Department of Urology, Franciscus Hospital, Rotterdam, The Netherlands., Lentjes KJ; Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands., Luiting HB; Department of Urology, Erasmus Medical Centre, Rotterdam, The Netherlands., van der Meer S; Department of Urology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands., Nieuwenhuijzen JA; Department of Urology, Amsterdam University Medical Centres location Vrije University Medical Centre, Amsterdam, The Netherlands., Noordzij MA; Department of Urology, Spaarne Gasthuis, Haarlem, Hoofddorp, The Netherlands., Nooter RI; Department of Urology, Franciscus Hospital, Rotterdam, The Netherlands., Notenboom C; Department of Urology, Erasmus Medical Centre, Rotterdam, The Netherlands., Oomen R; Department of Urology, Elisabeth TweeSteden Hospital, Tilburg, The Netherland., van Roermund J; Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands., de Rooij J; Department of Urology, Máxima Medical Centre, Veldhoven, The Netherlands., Roshani H; Department of Urology, HagaZiekenuis, Den Haag, The Netherlands., Schrier BP; Department of Urology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands., van der Slot MA; Department of Urology, Maasstad Hospital, Rotterdam, The Netherlands., Somford DM; Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands., Stelwagen PJ; Department of Urology, Amsterdam University Medical Centres location Vrije University Medical Centre, Amsterdam, The Netherlands., Stroux A; Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands., van der West A; Department of Urology, Spaarne Gasthuis, Haarlem, Hoofddorp, The Netherlands., Wijsman BP; Department of Urology, Elisabeth TweeSteden Hospital, Tilburg, The Netherland., Windt W; Department of Urology, Martini Hospital, Groningen, The Netherlands., van Zanten P; Department of Urology, HagaZiekenuis, Den Haag, The Netherlands., van Beek SC; Department of Urology, Erasmus Medical Centre, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Urologic oncology [Urol Oncol] 2022 Feb; Vol. 40 (2), pp. 60.e1-60.e9. Date of Electronic Publication: 2021 Jul 22.
DOI: 10.1016/j.urolonc.2021.06.018
Abstrakt: Background: Radical cystectomy with pelvic lymph node dissection is the recommended treatment in non-metastatic muscle-invasive bladder cancer (MIBC). In randomised trials, robot-assisted radical cystectomy (RARC) showed non-inferior short-term oncological outcomes compared with open radical cystectomy (ORC). Data on intermediate and long-term oncological outcomes of RARC are limited.
Objective: To assess the intermediate-term overall survival (OS) and recurrence-free survival (RFS) of patients with MIBC and high-risk non-MIBC (NMIBC) who underwent ORC versus RARC in clinical practice.
Methods and Materials: A nationwide retrospective study in 19 Dutch hospitals including patients with MIBC and high-risk NMIBC treated by ORC (n = 1086) or RARC (n = 386) between January 1, 2012 and December 31, 2015. Primary and secondary outcome measures were median OS and RFS, respectively. Survival outcomes were estimated using Kaplan-Meier curves. A multivariable Cox regression model was developed to adjust for possible confounders and to assess prognostic factors for survival including clinical variables, clinical and pathological disease stage, neoadjuvant therapy and surgical margin status.
Results: The median follow-up was 5.1 years (95% confidence interval ([95%CI] 5.0-5.2). The median OS after ORC was 5.0 years (95%CI 4.3-5.6) versus 5.8 years after RARC (95%CI 5.1-6.5). The median RFS was 3.8 years (95%CI 3.1-4.5) after ORC versus 5.0 years after RARC (95%CI 3.9-6.0). After multivariable adjustment, the hazard ratio for OS was 1.00 (95%CI 0.84-1.20) and for RFS 1.08 (95%CI 0.91-1.27) of ORC versus RARC. Patients who underwent ORC were older, had higher preoperative serum creatinine levels and more advanced clinical and pathological disease stage.
Conclusion: ORC and RARC resulted in similar intermediate-term OS and RFS in a cohort of almost 1500 MIBC and high-risk NMIBC.
Competing Interests: Conflict of interest All authors declare no conflicts of interest.
(Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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