Comparing Robotic-Assisted to Open Radical Cystectomy in the Management of Non-Muscle-Invasive Bladder Cancer: A Propensity Score Matched-Pair Analysis

Etienne Courboin^{1

2}, Romain Mathieu², Valentina Panetta³, Georges Mjaess¹, Romain Diamand⁴, Gregory Verhoest², Mathieu Roumiguié⁵, Anne Sophie Bajeot⁵, Francesco Soria⁶, Chiara Lonati⁷, Claudio Simeone⁷, Giuseppe Simone⁸, Umberto Anceschi⁸, Paolo Umari⁹, Ashwin Sridhar¹⁰, John Kelly¹⁰, Laura S Mertens¹¹, Rafael Sanchez-Salas¹², Anna Colomer¹², Maria Angela Cerruto¹³, Alessandro Antonelli¹³, Wojciech Krajewski¹⁴, Thierry Quackels¹, Alexandre Peltier⁴, Francesco Montorsi¹⁵, Alberto Briganti¹⁵, Jeremy Y C Teoh¹⁶, Benjamin Pradere^{17

18}, Marco Moschini¹⁵, Thierry Roumeguère^{1

4}, Simone Albisinni^{1

19}; European Association of Urology-Young Academic Urologists (EAU-YAU), Urothelial Carcinoma Working Group

Affiliations

¹ Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium.
² Department of Urology, CHU Rennes, 35000 Rennes, France.
³ L'altrastatistica S.R.L., Consultancy & Training, Biostatistics Office, 00100 Rome, Italy.
⁴ Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, 1070 Brussels, Belgium.
⁵ Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Paul-Sabatier University, 31000 Toulouse, France.
⁶ Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, 10024 Turin, Italy.
⁷ Department of Urology, Spedali Civili di Brescia, 25123 Brescia, Italy.
⁸ Department of Urology, Regina Elena National Cancer Institute, 00100 Rome, Italy.
⁹ Departement of Urology, Ospedale Maggiore della Caritá di Novara, Universitá del Piemonte Orientale, 28100 Novarra, Italy.
¹⁰ Division of Surgery and Interventional Sciences, University College London, London WC1E 6BT, UK.
¹¹ Department of Urology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands.
¹² Department of Urology, Institut Mutualiste Montsouris, 70123 Paris, France.
¹³ Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, 37100 Verona, Italy.
¹⁴ Department of Minimally Invasive and Robotic Urology, Wrocław Medical University, 50-556 Wroclaw, Poland.
¹⁵ Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy.
¹⁶ S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
¹⁷ Department of Urology, University of Vienna, 1010 Vienna, Austria.
¹⁸ Department of Urology, Hopital La Croix du Sud, 31000 Toulouse, France.
¹⁹ Urology Unit, Department of Surgical Sciences, Tor Vergata University Hospital, University of Rome Tor Vergata, 00100 Rome, Italy.

PMID: 37835425
PMCID: PMC10571883
DOI: 10.3390/cancers15194732

Comparing Robotic-Assisted to Open Radical Cystectomy in the Management of Non-Muscle-Invasive Bladder Cancer: A Propensity Score Matched-Pair Analysis

Etienne Courboin et al. Cancers (Basel). 2023.

. 2023 Sep 26;15(19):4732.

doi: 10.3390/cancers15194732.

Authors

Affiliations

¹ Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium.
² Department of Urology, CHU Rennes, 35000 Rennes, France.
³ L'altrastatistica S.R.L., Consultancy & Training, Biostatistics Office, 00100 Rome, Italy.
⁴ Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, 1070 Brussels, Belgium.
⁵ Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Paul-Sabatier University, 31000 Toulouse, France.
⁶ Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, 10024 Turin, Italy.
⁷ Department of Urology, Spedali Civili di Brescia, 25123 Brescia, Italy.
⁸ Department of Urology, Regina Elena National Cancer Institute, 00100 Rome, Italy.
⁹ Departement of Urology, Ospedale Maggiore della Caritá di Novara, Universitá del Piemonte Orientale, 28100 Novarra, Italy.
¹⁰ Division of Surgery and Interventional Sciences, University College London, London WC1E 6BT, UK.
¹¹ Department of Urology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands.
¹² Department of Urology, Institut Mutualiste Montsouris, 70123 Paris, France.
¹³ Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, 37100 Verona, Italy.
¹⁴ Department of Minimally Invasive and Robotic Urology, Wrocław Medical University, 50-556 Wroclaw, Poland.
¹⁵ Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy.
¹⁶ S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
¹⁷ Department of Urology, University of Vienna, 1010 Vienna, Austria.
¹⁸ Department of Urology, Hopital La Croix du Sud, 31000 Toulouse, France.
¹⁹ Urology Unit, Department of Surgical Sciences, Tor Vergata University Hospital, University of Rome Tor Vergata, 00100 Rome, Italy.

PMID: 37835425
PMCID: PMC10571883
DOI: 10.3390/cancers15194732

Abstract

Background: For non-muscle-invasive bladder cancer (NMIBC) requiring radical surgery, limited data are available comparing robotic-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) to open radical cystectomy (ORC). The objective of this study was to compare the two surgical techniques.

Methods: A multicentric cohort of 593 patients with NMIBC undergoing iRARC or ORC between 2015 and 2020 was prospectively gathered. Perioperative and pathologic outcomes were compared.

Results: A total of 143 patients operated on via iRARC were matched to 143 ORC patients. Operative time was longer in the iRARC group (p = 0.034). Blood loss was higher in the ORC group (p < 0.001), with a consequent increased post-operative transfusion rate in the ORC group (p = 0.003). Length of stay was longer in the ORC group (p = 0.007). Post-operative complications did not differ significantly (all p > 0.05). DFS at 60 months was 55.9% in ORC and 75.2% in iRARC with a statistically significant difference (p = 0.033) found in the univariate analysis.

Conclusion: We found that iRARC for patients with NMIBC is safe, associated with a lower blood loss, a lower transfusion rate and a shorter hospital stay compared to ORC. Complication rates were similar. No significant differences in survival analyses emerged across the two techniques.

Keywords: cystectomy; intracorporeal urinary diversion; non-muscle-invasive bladder cancer; open radical cystectomy; robotic-assisted radical cystectomy.

PubMed Disclaimer

Conflict of interest statement

Thierry Quackels: healthcare professional services agreement with Intuitive Surgical. Gregory Verhoest: healthcare professional services agreement with Intuitive Surgical. Others authors have nothing to disclose.

Figures

**Figure 1**
Kaplan–Meier curves for disease-free survival, cancer-specific survival and overall survival according to surgical approach.

See this image and copyright information in PMC

References

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Comparing Robotic-Assisted to Open Radical Cystectomy in the Management of Non-Muscle-Invasive Bladder Cancer: A Propensity Score Matched-Pair Analysis

Affiliations

Comparing Robotic-Assisted to Open Radical Cystectomy in the Management of Non-Muscle-Invasive Bladder Cancer: A Propensity Score Matched-Pair Analysis

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources