Efficacy of robot‐assisted radical cystectomy (RARC) in advanced bladder cancer: results from the International Radical Cystectomy Consortium (IRCC)
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| Titel: | Efficacy of robot‐assisted radical cystectomy (RARC) in advanced bladder cancer: results from the International Radical Cystectomy Consortium (IRCC) |
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| Autoren: | Koon Ho Rha, Erdem Canda, Douglas S. Scherr, Alex Mottrie, Alon Z. Weizer, Prokar Dasgupta, Ashok K. Hemal, Mani Menon, Eric M. Wallen, Stefan Siemer, Francis Schanne, Lee Richstone, Kenneth G. Nepple, Jihad H. Kaouk, Thomas J. Maatman, John G. Pattaras, Adam S. Kibel, Ali Al-Daghmin, Robert L. Grubb, Khurshid A. Guru, Vassilis Poulakis, Michael Woods, Raj S. Pruthi, James O. Peabody, Michael Stöckle, Peter Wiklund, Reza Ghavamian, Ketan K. Badani, Gregory E. Wilding, Timothy O. Wilson, Yi Shi, M. Derya Balbay, Eric C. Kauffman, Juan Palou Redorta |
| Weitere Verfasser: | 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, Rha, Koon Ho |
| Quelle: | BJU INTERNATIONAL r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau Institut dInvestigació Biomèdica Sant Pau (IIB Sant Pau) instname |
| Verlagsinformationen: | Wiley, 2014. |
| Publikationsjahr: | 2014 |
| Schlagwörter: | Adult, Male, Efficacy, efficacy, Cystectomy/methods, robot-assisted, Cystectomy, Postoperative Complications/mortality, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, Cystectomy/adverse effects, Health Sciences, 80 and over, Humans, radical cystectomy, Aged, Retrospective Studies, Aged, 80 and over, 2. Zero hunger, IRCC, Radical Cystectomy, Robotics, Middle Aged, Bladder Cancer, Robot‐Assisted, 3. Good health, Treatment Outcome, Urinary Bladder Neoplasms, Internal Medicine and Specialties, Urinary Bladder Neoplasms/mortality, Urinary Bladder Neoplasms/surgery, bladder cancer, Postoperative Complications/etiology, Female |
| Beschreibung: | ObjectiveTo characterise the surgical feasibility and outcomes of robot‐assisted radical cystectomy (RARC) for pathological T4 bladder cancer.Patients and MethodsRetrospective 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.ResultsIn 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.ConclusionsRARC for pT4 bladder cancer is surgically feasible but entails significant morbidity and mortality.BMI was independent predictor of complications in pT4 patients. |
| Publikationsart: | Article |
| Dateibeschreibung: | 98~103; application/pdf |
| Sprache: | English |
| ISSN: | 1464-410X 1464-4096 |
| DOI: | 10.1111/bju.12569 |
| Zugangs-URL: | http://deepblue.lib.umich.edu/bitstream/2027.42/107553/1/bju12569.pdf https://pubmed.ncbi.nlm.nih.gov/24219170 https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=9238 https://hdl.handle.net/2027.42/107553 https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=9238 https://yonsei.pure.elsevier.com/en/publications/efficacy-of-robot-assisted-radical-cystectomy-rarc-in-advanced-bl https://bjui-journals.onlinelibrary.wiley.com/doi/10.1111/bju.12569 http://www.poulakis-urology.com/images/news/2014/bju12569.pdf https://deepblue.lib.umich.edu/handle/2027.42/107553 https://einstein.pure.elsevier.com/en/publications/efficacy-of-robot-assisted-radical-cystectomy-rarc-in-advanced-bl-2 https://www.ncbi.nlm.nih.gov/pubmed/24219170 |
| Rights: | Wiley Online Library User Agreement CC BY NC ND |
| Dokumentencode: | edsair.doi.dedup.....0f45c70a2c28e6f4ce38f37d385a14ea |
| Datenbank: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | ObjectiveTo characterise the surgical feasibility and outcomes of robot‐assisted radical cystectomy (RARC) for pathological T4 bladder cancer.Patients and MethodsRetrospective 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.ResultsIn 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.ConclusionsRARC 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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| ISSN: | 1464410X 14644096 |
| DOI: | 10.1111/bju.12569 |