Intermediate-Term Oncologic Outcomes of Robot-Assisted Radical Cystectomy for Urothelial Carcinoma
| Autor: | Scott Tobis, Clayton Lau, Kristina Wittig, Kevin Chan, Nora Ruel, Timothy G. Wilson, Jonathan Yamzon, Bertram Yuh, Jennifer Linehan, Robert R. Torrey |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Urology medicine.medical_treatment Kaplan-Meier Estimate Cystectomy Disease-Free Survival Risk Factors Carcinoma medicine Humans Lymph node Neoadjuvant therapy Aged Proportional Hazards Models Carcinoma Transitional Cell Proportional hazards model business.industry Age Factors Cancer Perioperative Middle Aged medicine.disease Neoadjuvant Therapy Surgery Treatment Outcome medicine.anatomical_structure Urinary Bladder Neoplasms Chemotherapy Adjuvant Female Lymph Nodes Neoplasm Recurrence Local Positive Surgical Margin business |
| Zdroj: | Journal of Endourology. 28:939-945 |
| ISSN: | 1557-900X 0892-7790 |
| Popis: | 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).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.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.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: | OpenAIRE |
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