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Beitragstitel Open versus robotic cystectomy: a propensity score matched analysis comparing survival outcomes
Beitragscode M015
Autor:innen
  1. Marco Moschini Luzerner Kantonsspital
  2. Stefania Zamboni Luzerner Kantonsspital
  3. Fabian Aschwanden Luzerner Kantonsspital Präsentierende:r
  4. Francesco Soria Vienna General Hospital
  5. Romain Mathieu Vienna General Hospital
  6. Evanguelos Xylinas Bichat Hospital, Paris Descartes University, Paris, France
  7. Wei Shen Tan University College London
  8. John D Kelly University College London
  9. Giuseppe Simone Regina Elena National Cancer Institute, Rome, Italy
  10. Anoop Meraney Hartford Healthcare Medical Group
  11. Suprita Krishna University of Minnesota, Department of Urology, Minneapolis, MN
  12. Badrinath Konety University of Minnesota, Department of Urology, Minneapolis, MN
  13. Agostino Mattei Luzerner Kantonsspital
  14. Philipp Baumeister Luzerner Kantonsspital
  15. Livio Mordasini Luzerner Kantonsspital
  16. Francesco Montorsi Department of Urology, Urological Research Institute, San Raffaele Scientific Institute, Milan, Italy
  17. Alberto Briganti Department of Urology, Urological Research Institute, San Raffaele Scientific Institute, Milan, Italy
  18. Andrea Gallina Department of Urology, Urological Research Institute, San Raffaele Scientific Institute, Milan, Italy
  19. Rafael Sanchez-Salas Department of Urology, L'Institut Mutualiste Montsouris, Université Paris Descartes, Paris, France
  20. Xavier Cathelineau Department of Urology, L'Institut Mutualiste Montsouris, Université Paris Descartes, Paris, France
  21. Michael Rink Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  22. Andrea Necchi Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  23. Pierre I. Karakiewicz Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Quebec, Canada
  24. Morgan Rouprêt Sorbonne Université, GRC n°5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, F-75013 PARIS, France
  25. Anthony Koupparis Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Bristol, UK.
  26. Wassim Kassouf Department of Urology, McGill University Health Center, Montreal, QC, Canada
  27. Douglas S Scherr Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA
  28. Guillaume Ploussard Department of Urology, La Croix du sud Hospital, Toulouse, France.
  29. Stephen A. Boorjian Department of Urology, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA
  30. Yair Lotan Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
  31. Prasanna Sooriakumaran Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
  32. Shahrokh F. Shariat Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital
Präsentationsform Freie Mitteilungen
Themengebiete
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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.