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Efficacy of robot-assisted radical cystectomy (RARC) in advanced bladder cancer: results from the International Radical Cystectomy Consortium (IRCC)

 Ali Al-Daghmin  ;  Eric C. Kauffman  ;  Yi Shi  ;  Ketan Badani  ;  M. Derya Balbay  ;  Erdem Canda  ;  Prokar Dasgupta  ;  Reza Ghavamian  ;  Robert Grubb III  ;  Ashok Hemal  ;  Jihad Kaouk  ;  Adam S. Kibel  ;  Thomas Maatman  ;  Mani Menon  ;  Alex Mottrie  ;  Kenneth Nepple  ;  John G. Pattaras  ;  James O. Peabody  ;  Vassilis Poulakis  ;  Raj Pruthi  ;  Juan Palou Redorta  ;  Koon-Ho Rha  ;  Lee Richstone  ;  Francis Schanne  ;  Douglas S. Scherr  ;  Stefan Siemer  ;  Michael Stöckle  ;  Eric M. Wallen  ;  Alon Weizer  ;  Peter Wiklund  ;  Timothy Wilson  ;  Gregory Wilding  ;  Michael Woods  ;  Khurshid A. Guru 
 BJU INTERNATIONAL, Vol.114(1) : 98-103, 2014 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Cystectomy/adverse effects ; Cystectomy/methods* ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications/etiology ; Postoperative Complications/mortality ; Retrospective Studies ; Risk Factors ; Robotics* ; Treatment Outcome ; Urinary Bladder Neoplasms/mortality ; Urinary Bladder Neoplasms/surgery*
IRCC ; bladder cancer ; efficacy ; radical cystectomy ; robot-assisted
OBJECTIVE: To characterise the surgical feasibility and outcomes of robot-assisted radical cystectomy (RARC) for pathological T4 bladder cancer. PATIENTS AND METHODS: Retrospective evaluation of a prospectively maintained International Radical Cystectomy Consortium database was conducted for 1118 patients who underwent RARC between 2003 and 2012. We dichotomised patients based on pathological stage (≤pT3 vs pT4) and evaluated demographic, operative and pathological variables in relation to morbidity and mortality. RESULTS: In all, 1000 ≤pT3 and 118 pT4 patients were evaluated. The pT4 patients were older than the ≤pT3 patients (P = 0.001). The median operating time and blood loss were 386 min and 350 mL vs 396 min and 350 mL for p T4 and ≤pT3, respectively. The complication rate was similar (54% vs 58%; P = 0.64) among ≤pT3 and pT4 patients, respectively. The overall 30- and 90-day mortality rate was 0.4% and 1.8% vs 4.2% and 8.5% for ≤pT3 vs pT4 patients (P < 0.001), respectively. The body mass index (BMI), American Society of Anesthesiology score, length of hospital stay (LOS) >10 days, and 90-day readmission were significantly associated with complications in pT4 patients. Meanwhile, BMI, LOS >10 days, grade 3-5 complications, 90-day readmission, smoking, previous abdominal surgery and neoadjuvant chemotherapy were significantly associated with mortality in pT4 patients. On multivariate analysis, BMI was an independent predictor of complications in pT4 patients, but not for mortality. CONCLUSIONS: RARC for pT4 bladder cancer is surgically feasible but entails significant morbidity and mortality. BMI was independent predictor of complications in pT4 patients.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
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