Long-term oncologic outcomes of robot-assisted radical cystectomy: update series from a high-volume robotic center beyond 10 years of follow-up.

Autor: Bravi CA; Division of Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Via Olgettina 60, 20131, Milan, Italy. carloandrea.bravi@gmail.com.; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium. carloandrea.bravi@gmail.com.; ORSI Academy, Ghent, Belgium. carloandrea.bravi@gmail.com., Piazza P; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.; ORSI Academy, Ghent, Belgium.; Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Mazzone E; Division of Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Via Olgettina 60, 20131, Milan, Italy., Dell'Oglio P; Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.; Department of Urology, Antoni Van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands.; Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., Rosiello G; Division of Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Via Olgettina 60, 20131, Milan, Italy., Martini A; Division of Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Via Olgettina 60, 20131, Milan, Italy., Stabile A; Division of Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Via Olgettina 60, 20131, Milan, Italy., Moschini M; Division of Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Via Olgettina 60, 20131, Milan, Italy., Amato M; ORSI Academy, Ghent, Belgium.; Department of Urology, University of Modena and Reggio Emilia, Modena, Italy., Sarchi L; ORSI Academy, Ghent, Belgium.; Department of Urology, University of Modena and Reggio Emilia, Modena, Italy., Peraire M; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.; ORSI Academy, Ghent, Belgium., Farinha R; ORSI Academy, Ghent, Belgium., Scarcella S; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.; ORSI Academy, Ghent, Belgium., Puliatti S; ORSI Academy, Ghent, Belgium.; Department of Urology, University of Modena and Reggio Emilia, Modena, Italy., Knipper S; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.; ORSI Academy, Ghent, Belgium.; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany., Berquin C; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium., Develtere D; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium., Sinatti C; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium., Van Puyvelde H; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium., De Groote R; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium., De Naeyer G; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium., D'Hondt F; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium., Schatteman P; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium., Briganti A; Division of Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Via Olgettina 60, 20131, Milan, Italy., Montorsi F; Division of Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Via Olgettina 60, 20131, Milan, Italy., Mottrie A; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.; ORSI Academy, Ghent, Belgium.
Jazyk: angličtina
Zdroj: Journal of robotic surgery [J Robot Surg] 2023 Jun; Vol. 17 (3), pp. 1143-1150. Date of Electronic Publication: 2022 Nov 15.
DOI: 10.1007/s11701-022-01473-y
Abstrakt: Long-term oncologic data on patients undergoing robot-assisted radical cystectomy (RARC) for non-metastatic bladder cancer (BCa) are limited. The purpose of this study is to describe long-term oncologic outcomes of patients receiving robotic radical cystectomy at a high-volume European Institution. We analyzed data of 107 patients treated with RARC between 2003 and 2012 at a high-volume robotic center. Clinical, pathologic, and survival data at the latest follow-up were collected. Clinical recurrence (CR)-free survival, cancer-specific mortality (CSM)-free survival, and overall survival (OS) were plotted using Kaplan-Meier survival curves. Cox proportional hazard models investigated predictors of CR and CSM. Competing-risk regressions were utilized to depict cumulative incidences of death from BCa and death from other causes after RARC at long term. Pathologic nonorgan-confined BCa was found in 40% of patients, and 7 (7%) patients had positive soft tissue surgical margins. Median (interquartile range [IQR]) number of nodes removed was 11 (6, 14), and 26% of patients had pN + disease. Median (IQR) follow-up for survivors was 123 (117, 149) months. The 12-year CR-free, CSM-free and overall survival were 55% (95% confidence interval [CI] 44%, 65%), 62% (95% CI 50%, 72%), and 34% (95% CI 24%, 44%), respectively. Nodal involvement on final pathology was associated with poor prognosis on multivariable competing risk analysis. The cumulative incidence of non-cancer death exceeded that of death from BCa after approximately ten years after RARC. We provided relevant data on oncologic outcomes of RARC at a high-volume robotic center, with acceptable rates of clinical recurrence and cancer-specific survival at long-term. In patients treated with RARC, the cumulative incidence of death from causes other than BCa is non-negligible, and should be taken into consideration for post-operative follow-up.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
Databáze: MEDLINE
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