Beitragstitel | Open versus robotic cystectomy: a propensity score matched analysis comparing survival outcomes |
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Beitragscode | M015 |
Autor:innen | |
Präsentationsform | Freie Mitteilungen |
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Abstract-Text |
Introduction: Robotic-assisted radical cystectomy (RARC) has gained popularity as an alternative to open radical cystectomy (ORC). While several studies analyzed perioperative and short terms effects, sparse data exists regarding survival. Our study aims to assess the differential effect of RARC versus ORC on survival outcomes in matched analyses performed on a large multicentric cohort. Materials and methods: The study included 9757 patients with urothelial carcinoma of the bladder (UCB) treated in a consecutive manner at each of 25 institutions. All patients underwent radical cystectomy with bilateral pelvic lymphadenectomy. To adjust for potential selection bias, propensity-score matching 2:1 was performed with three ORC patients matched to one RARC patient. The propensity-matched cohort included 1374 patients. Multivariable competing risk analyses accounting for death of other causes, tested association of surgical technique with recurrence and cancer specific mortality (CSM), before and after propensity-score matching. Results: Overall, 767 (7.8%) patients underwent RARC and 8990 (92.2%) ORC. The median follow-up before and after propensity matching was 81 and 102 months, respectively. In the overall population, the 3-year recurrence rates and CSM were 37% vs 26% and 34% vs 24% for ORC vs. RARC (all p value> 0.1), respectively. On multivariable Cox regression analyses, RARC and ORC had similar recurrence and CSM rates before and after matching (all p value> 0.1). Conclusions: Patients treated with RARC and ORC have similar survival outcomes. This data is helpful in consulting patients until long term survival outcomes of level one evidence is available. |