Laparoscopic versus open radical cystectomy for muscle-invasive bladder cancer: a single institute comparative analysis

Abstract

Background: Open radical cystectomy (ORC) is the gold standard of treatment for muscle-invasive bladder cancer. Laparoscopic radical cystectomy (LRC) has emerged to provide an alternative.

Methods: Between 2006 and 2012, 155 patients who underwent LRC or ORC were compared (mean follow-up 53 months).

Results: The ORC group had shorter operative times (p < 0.0001), more blood loss (p < 0.00001), more transfusion requirement (p < 0.00001), longer postoperative length of hospital stay (p < 0.00001) and more morphine requirement (p = 0.02). No difference was found regarding lymph node yield (p = 0.07), positive margins (p = 0.11), cystectomy pathology results (p > 0.05) and positive lymph nodes (p = 0.02). The ORC group had less intraoperative complications (p = 0.03). No difference was found between the two groups regarding 5-year overall survival (p = 0.93), cancer-specific survival (p = 0.7) and recurrence-free survival (p = 0.62).

Conclusion: LRC can be considered as an alternative to ORC with good operative and postoperative results in addition to comparable 5-year survival results.