Open Versus Robotic Cystectomy: A Propensity Score Matched Analysis Comparing Survival Outcomes: Journal of Clinical Medicine

Marco Moschini, Stefania Zamboni, Francesco Soria, Romain Mathieu, Evanguelos Xylinas, Wei Shen Tan, John D. Kelly, Giuseppe Simone, Anoop Meraney, Suprita Krishna, Badrinath Konety, Agostino Mattei, Philipp Baumeister, Livio Mordasini, Francesco Montorsi, Alberto Briganti, Andrea Gallina, Armando Stabile, Rafael Sanchez-Salas, Xavier CathelineauMichael Rink, Andrea Necchi, Pierre I. Karakiewicz, Morgan Rouprêt, Anthony Koupparis, Wassim Kassouf, Douglas S. Scherr, Guillaume Ploussard, Stephen A. Boorjian, Yair Lotan, Prasanna Sooriakumaran, Shahrokh F. Shariat

Research output: Contribution to journalArticle

Abstract

BACKGROUND: To assess the differential effect of robotic assisted radical cystectomy (RARC) versus open radical cystectomy (ORC) on survival outcomes in matched analyses performed on a large multicentric cohort. METHODS: The study included 9757 patients with urothelial bladder cancer (BCa) 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 two 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 values > 0.1), respectively. On multivariable Cox regression analyses, RARC and ORC had similar recurrence and CSM rates before and after matching (all p values > 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.
Original languageEnglish
JournalJournal of Clinical Medicine
Volume8
Issue number8
DOIs
Publication statusPublished - 2019

Keywords

  • survival
  • bladder cancer
  • radical cystectomy
  • open
  • propensity score
  • robotic-assisted

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    Moschini, M., Zamboni, S., Soria, F., Mathieu, R., Xylinas, E., Tan, W. S., Kelly, J. D., Simone, G., Meraney, A., Krishna, S., Konety, B., Mattei, A., Baumeister, P., Mordasini, L., Montorsi, F., Briganti, A., Gallina, A., Stabile, A., Sanchez-Salas, R., ... Shariat, S. F. (2019). Open Versus Robotic Cystectomy: A Propensity Score Matched Analysis Comparing Survival Outcomes: Journal of Clinical Medicine. Journal of Clinical Medicine, 8(8). https://doi.org/10.3390/jcm8081192